Provider Demographics
NPI:1417604612
Name:CAPORASO, DESIREE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:
Last Name:CAPORASO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 IRONWORKS RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-1224
Mailing Address - Country:US
Mailing Address - Phone:203-843-5335
Mailing Address - Fax:
Practice Address - Street 1:54 IRONWORKS RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:CT
Practice Address - Zip Code:06413-1224
Practice Address - Country:US
Practice Address - Phone:203-843-5335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT119061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical