Provider Demographics
NPI:1417157058
Name:CARUSO, STEVEN J (PHD, LP, LMFT, MA)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:CARUSO
Suffix:
Gender:M
Credentials:PHD, LP, LMFT, MA
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:'OLAUF'
Other - Last Name:CARUSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5218 W WHISPERING WIND DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-2908
Mailing Address - Country:US
Mailing Address - Phone:480-440-5321
Mailing Address - Fax:
Practice Address - Street 1:19025 WILEYS WELL RD
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-2287
Practice Address - Country:US
Practice Address - Phone:760-218-8063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46282106H00000X
ORT0717106H00000X
AZ4784103TC0700X
CA28479103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist