Provider Demographics
NPI:1245768977
Name:CARUSO, PHILLIP (LPC)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:CARUSO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 ROUTE 10 APT 2
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1552
Mailing Address - Country:US
Mailing Address - Phone:201-274-5594
Mailing Address - Fax:
Practice Address - Street 1:268 GREEN VILLAGE RD
Practice Address - Street 2:
Practice Address - City:GREEN VILLAGE
Practice Address - State:NJ
Practice Address - Zip Code:07935-3027
Practice Address - Country:US
Practice Address - Phone:201-274-5594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00441500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional