Provider Demographics
NPI:1740828607
Name:MACARUSO, TAYLOR EVELYN (LICSW)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:EVELYN
Last Name:MACARUSO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:E
Other - Last Name:LAMBERTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:77 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1193
Mailing Address - Country:US
Mailing Address - Phone:508-589-5333
Mailing Address - Fax:774-250-2693
Practice Address - Street 1:1 CLARKS HL STE 302
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8172
Practice Address - Country:US
Practice Address - Phone:508-589-5333
Practice Address - Fax:774-250-2693
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical