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General NPI Number Information
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NPI Number | 1417157058
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Entity Type | Individual
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Provider Name | STEVEN J CARUSO PHD, LP, LMFT, MA
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Gender | Male
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 19025 WILEYS WELL RD
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City | BLYTHE
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State | CA
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Zip | 92225-2287
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Country | US
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Telephone | 760-218-8063
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Fax |
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Provider Business Mailing Address
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Address Line | 5218 W WHISPERING WIND DR
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City | GLENDALE
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State | AZ
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Zip | 85310-2908
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Country | US
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Telephone | 480-440-5321
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 46282
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0717
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4784
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 28479
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License Number State | CA
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