Provider Demographics
NPI:1811941990
Name:CARUGNO, KATHERINE LOUISE (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LOUISE
Last Name:CARUGNO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:LOUISE
Other - Last Name:BOYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 529
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-0529
Mailing Address - Country:US
Mailing Address - Phone:609-978-6083
Mailing Address - Fax:
Practice Address - Street 1:347 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3015
Practice Address - Country:US
Practice Address - Phone:609-978-6083
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045767001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2244568000OtherAMERIHEALTH
7908290OtherAETNA
051625Medicare ID - Type Unspecified