Provider Demographics
NPI:1508123589
Name:CARUSO, VICTOR A (LMFT)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:A
Last Name:CARUSO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7637 BAUBLE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-2614
Mailing Address - Country:US
Mailing Address - Phone:702-327-7216
Mailing Address - Fax:
Practice Address - Street 1:2298 W HORIZON RIDGE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2698
Practice Address - Country:US
Practice Address - Phone:702-327-7216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1012106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist