Healthcare Provider Details

I. General information

NPI: 1841605664
Provider Name (Legal Business Name): CATHERINE ROSS CARUSO MSW, LCSW, CADC III
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 11/04/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 BEAVERCREEK RD STE 102
OREGON CITY OR
97045-4287
US

IV. Provider business mailing address

418 BEAVERCREEK RD STE 102
OREGON CITY OR
97045-4287
US

V. Phone/Fax

Practice location:
  • Phone: 971-203-0683
  • Fax: 503-212-0174
Mailing address:
  • Phone: 971-203-0683
  • Fax: 503-212-0174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number19-07-02
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7596
License Number StateOR

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: