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General NPI Number Information
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NPI Number | 1295790731
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Entity Type | Individual
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Provider Name | PATRICK CARUSO LICSW
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 7307 N DIVISION ST SUITE 311
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City | SPOKANE
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State | WA
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Zip | 99208-6545
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Country | US
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Telephone | 509-465-2300
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Fax | 509-465-9501
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Provider Business Mailing Address
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Address Line | 21980 E COUNTRY VISTA DR STE 200
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-6025
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Country | US
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Telephone | 509-465-2300
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Fax | 509-465-9501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LW00004217
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License Number State | WA
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