Provider Demographics
NPI:1326443847
Name:LORRAINE E CAPUTO LCSW
Entity Type:Organization
Organization Name:LORRAINE E CAPUTO LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAPUTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-698-3032
Mailing Address - Street 1:511 VALLEY ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1381
Mailing Address - Country:US
Mailing Address - Phone:718-698-3032
Mailing Address - Fax:718-761-3162
Practice Address - Street 1:511 VALLEY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1381
Practice Address - Country:US
Practice Address - Phone:718-698-3032
Practice Address - Fax:718-761-3162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC050129001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ050576Medicare PIN