MEDICARE: DR. STEVEN J CARUSO PHD, LP, LMFT, MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	46282	CA
2	106H00000X	Marriage & Family Therapist	T0717	OR
3	103TC0700X	Clinical Psychologist	4784	AZ
4	103TC0700X	Clinical Psychologist	28479	CA

General Provider Information

NPI Number	:	1417157058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN J CARUSO PHD, LP, LMFT, MA

Provider Business Mailing Address
First Line	:	5218 W WHISPERING WIND DR
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85310-2908
Country	:	US
Telephone Number	:	480-440-5321
Fax Number	:

Provider Business Practice Location Address
First Line	:	19025 WILEYS WELL RD
Second Line	:
City	:	BLYTHE
State	:	CA
Zip	:	92225-2287
Country	:	US
Telephone Number	:	760-218-8063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	03/13/2017

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