Provider Demographics
NPI:1215565494
Name:CARUANA, DANIEL JAMES (LSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:CARUANA
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 HARCOURT RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2073
Mailing Address - Country:US
Mailing Address - Phone:317-338-4850
Mailing Address - Fax:317-338-4890
Practice Address - Street 1:8401 HARCOURT RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2073
Practice Address - Country:US
Practice Address - Phone:317-338-4850
Practice Address - Fax:317-338-4890
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33009170A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker