Provider Demographics
NPI:1679253413
Name:ARICOLA, CARISSA MARIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:CARISSA
Middle Name:MARIA
Last Name:ARICOLA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CARISSA
Other - Middle Name:MARIA
Other - Last Name:ARICOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:89 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3039
Mailing Address - Country:US
Mailing Address - Phone:732-908-0822
Mailing Address - Fax:
Practice Address - Street 1:1683 HIGHWAY 88 STE A
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3065
Practice Address - Country:US
Practice Address - Phone:732-840-5266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty