Provider Demographics
NPI:1871895706
Name:CRISCUOLO, EUGENIA (LCSW)
Entity type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:CRISCUOLO
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 1:540 ROUTE 22 EAST
Mailing Address - Street 2:CATHOLIC CHARITIES, DIOCESE OF METUCHEN
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2405
Mailing Address - Country:US
Mailing Address - Phone:908-722-1881
Mailing Address - Fax:908-704-0215
Practice Address - Street 1:540 ROUTE 22 EAST
Practice Address - Street 2:CATHOLIC CHARITIES, DIOCESE OF METUCHEN
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2405
Practice Address - Country:US
Practice Address - Phone:908-722-1881
Practice Address - Fax:908-704-0215
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC002884001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical