Provider Demographics
NPI:1356500342
Name:SANTORO, JOHN JOSEPH (MA, LCADC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:SANTORO
Suffix:
Gender:M
Credentials:MA, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 POWERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-8705
Mailing Address - Country:US
Mailing Address - Phone:973-316-1862
Mailing Address - Fax:973-316-1882
Practice Address - Street 1:130 POWERVILLE RD
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-8705
Practice Address - Country:US
Practice Address - Phone:973-316-1862
Practice Address - Fax:973-316-1882
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00142400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)