Provider Demographics
NPI:1295585818
Name:PORCARO, CARISSA MARIE (MS, CRC)
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:MARIE
Last Name:PORCARO
Suffix:
Gender:F
Credentials:MS, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13B SHAW DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03868-5711
Mailing Address - Country:US
Mailing Address - Phone:207-899-9154
Mailing Address - Fax:
Practice Address - Street 1:78 S COURTLAND ST STE 3
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-2852
Practice Address - Country:US
Practice Address - Phone:570-856-4232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor