Provider Demographics
NPI:1528552783
Name:CARUSO, EILEEN LINDA (LSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:LINDA
Last Name:CARUSO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MRS
Other - First Name:EILEEN
Other - Middle Name:LINDA
Other - Last Name:CARUSO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:6 SPLIT ROCK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2859
Mailing Address - Country:US
Mailing Address - Phone:201-264-7332
Mailing Address - Fax:
Practice Address - Street 1:22-08 ROUTE 208
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2609
Practice Address - Country:US
Practice Address - Phone:201-740-7086
Practice Address - Fax:201-791-0147
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05391400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker