Provider Demographics
NPI:1427148444
Name:MAURO, PAUL ROBERT (LCSW, CASAC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ROBERT
Last Name:MAURO
Suffix:
Gender:M
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NEPTUNE BLVD
Mailing Address - Street 2:SUITE 9P
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4651
Mailing Address - Country:US
Mailing Address - Phone:516-532-6213
Mailing Address - Fax:
Practice Address - Street 1:25 NEPTUNE BLVD
Practice Address - Street 2:SUITE 9P
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4651
Practice Address - Country:US
Practice Address - Phone:516-532-6213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7393101YA0400X
NYR0492451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical