Provider Demographics
NPI:1639614464
Name:CARUSO, ANTONIETTA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANTONIETTA
Middle Name:
Last Name:CARUSO
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 1:2 RUNNING BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-6917
Mailing Address - Country:US
Mailing Address - Phone:908-507-8826
Mailing Address - Fax:
Practice Address - Street 1:24 MINE ST
Practice Address - Street 2:SUITE 3D
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-6500
Practice Address - Country:US
Practice Address - Phone:908-507-8826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046164001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical