Provider Demographics
NPI:1740548775
Name:CARACCIOLI, ELAINE BISHARA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:BISHARA
Last Name:CARACCIOLI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:142 W 2ND ST
Mailing Address - Street 2:1 A
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2547
Mailing Address - Country:US
Mailing Address - Phone:315-216-4776
Mailing Address - Fax:315-216-4783
Practice Address - Street 1:142 W 2ND ST
Practice Address - Street 2:1 A
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2547
Practice Address - Country:US
Practice Address - Phone:315-216-4776
Practice Address - Fax:315-216-4783
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0745671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical