Provider Demographics
NPI:1831821743
Name:CASAMENTO, STEVEN PAUL (LAC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:CASAMENTO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147A S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-2150
Mailing Address - Country:US
Mailing Address - Phone:201-874-9504
Mailing Address - Fax:
Practice Address - Street 1:46 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1864
Practice Address - Country:US
Practice Address - Phone:201-588-3491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00504900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health