Healthcare Provider Details

I. General information

NPI: 1881024693
Provider Name (Legal Business Name): CAROLINE FARAONE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2013
Last Update Date: 11/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W 8TH ST APT 3R
PLAINFIELD NJ
07060-2347
US

IV. Provider business mailing address

440 W 8TH ST APT 3R
PLAINFIELD NJ
07060-2347
US

V. Phone/Fax

Practice location:
  • Phone: 732-850-5764
  • Fax: 732-815-7517
Mailing address:
  • Phone: 732-850-5764
  • Fax: 732-815-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05400100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: