Provider Demographics
NPI:1811589377
Name:CACACE, MARIA LYNN (LPC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LYNN
Last Name:CACACE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 MORRIS AVE APT 405
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-0001
Mailing Address - Country:US
Mailing Address - Phone:732-815-6950
Mailing Address - Fax:
Practice Address - Street 1:540 MORRIS AVE APT 405
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-0001
Practice Address - Country:US
Practice Address - Phone:732-815-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01106500101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional