Provider Demographics
NPI:1447703095
Name:RICCIO-COLLINS, CARA LYNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:LYNE
Last Name:RICCIO-COLLINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 ROUTE 516
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-4900
Mailing Address - Country:US
Mailing Address - Phone:732-707-4100
Mailing Address - Fax:
Practice Address - Street 1:3901 ROUTE 516
Practice Address - Street 2:SUITE 1C
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-4900
Practice Address - Country:US
Practice Address - Phone:732-707-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053130001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical