Provider Demographics
NPI:1093748790
Name:MACALUSO, EVAMARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:EVAMARIE
Middle Name:
Last Name:MACALUSO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4175
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-4175
Mailing Address - Country:US
Mailing Address - Phone:941-343-7683
Mailing Address - Fax:
Practice Address - Street 1:306 N RHODES AVE STE 110
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-4671
Practice Address - Country:US
Practice Address - Phone:941-343-7683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4709101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health