Provider Demographics
NPI:1427413210
Name:CARACCIO, STEVE LAZARUS (LSW)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:LAZARUS
Last Name:CARACCIO
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BECKWITH PL
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1207
Mailing Address - Country:US
Mailing Address - Phone:201-674-2950
Mailing Address - Fax:
Practice Address - Street 1:610 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3607
Practice Address - Country:US
Practice Address - Phone:201-265-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06059000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker