# MR. DEREK S. CARUSO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1871841577
- **Gender:** Man
- **Credential:** MSW, MSN, PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | F405069 | NY | Yes |

## Other

- **Enumeration date:** 08/28/2012
- **Last updated:** 08/24/2026

## 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 |