Provider Demographics
NPI:1295790731
Name:CARUSO, PATRICK (LICSW)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:CARUSO
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21980 E COUNTRY VISTA DR
Mailing Address - Street 2:STE 200
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-6025
Mailing Address - Country:US
Mailing Address - Phone:509-465-2300
Mailing Address - Fax:509-465-9501
Practice Address - Street 1:7307 N DIVISION ST
Practice Address - Street 2:SUITE 311
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6545
Practice Address - Country:US
Practice Address - Phone:509-465-2300
Practice Address - Fax:509-465-9501
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00004217104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker