Provider Demographics
NPI:1841970860
Name:CARUSO, MICHELLE LYNN (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LYNN
Last Name:CARUSO
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 MAIN ST
Mailing Address - Street 2:BUILDING 2, STE 2B
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468
Mailing Address - Country:US
Mailing Address - Phone:203-628-2468
Mailing Address - Fax:
Practice Address - Street 1:755 MAIN ST
Practice Address - Street 2:BUILDING 2, STE 2B
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468
Practice Address - Country:US
Practice Address - Phone:203-628-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6594101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional