Provider Demographics
NPI:1659409688
Name:PIZZA CARUSO, ANNA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:PIZZA CARUSO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 MIRE CT
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1626
Mailing Address - Country:US
Mailing Address - Phone:985-643-7288
Mailing Address - Fax:985-649-7573
Practice Address - Street 1:105 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 305
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5544
Practice Address - Country:US
Practice Address - Phone:985-643-7288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA49501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical