Provider Demographics
NPI:1609232743
Name:KANE-CAVAIOLA, CAROLANN (LCADC)
Entity Type:Individual
Prefix:
First Name:CAROLANN
Middle Name:
Last Name:KANE-CAVAIOLA
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:PT PLEASANT BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2526
Mailing Address - Country:US
Mailing Address - Phone:732-899-0753
Mailing Address - Fax:732-899-0850
Practice Address - Street 1:337 RIVER AVE
Practice Address - Street 2:
Practice Address - City:PT PLEASANT BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08742-2526
Practice Address - Country:US
Practice Address - Phone:732-773-2757
Practice Address - Fax:732-899-0850
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00164100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)