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Individual
MR. DEREK S. CARUSO
Active
Individual
MR. DEREK S. CARUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, MSN, PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
086771
NY
1041C0700X
Clinical Social Worker
084067
NY
163W00000X
Registered Nurse
744382
NY
163WP0808X
Psychiatric/Mental Health Registered Nurse
744382
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405069
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03482717
—
NY
01
—
10000022616
CAQH GROUP ID
NY
01
—
1184445835
TYPE 2 NPI - ORGANIZATION
NY
01
—
13545756
CAQH ID #
NY
Enumeration date
08/28/2012
Last updated
08/24/2026
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