Provider Demographics
NPI:1821128463
Name:CARUSO, MAUREEN M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:M
Last Name:CARUSO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:M
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 703
Mailing Address - Street 2:480 BROADWAY, SUITE 314
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-0703
Mailing Address - Country:US
Mailing Address - Phone:518-429-3826
Mailing Address - Fax:518-587-8241
Practice Address - Street 1:480 BROADWAY
Practice Address - Street 2:SUITE 314
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2246
Practice Address - Country:US
Practice Address - Phone:518-429-3826
Practice Address - Fax:518-587-8241
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP065687-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00639496Medicaid