Provider Demographics
NPI:1073657375
Name:MARC A CAPLAN PHD PA
Entity type:Organization
Organization Name:MARC A CAPLAN PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PA
Authorized Official - Phone:505-526-4222
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-0249
Mailing Address - Country:US
Mailing Address - Phone:505-526-4222
Mailing Address - Fax:505-526-4228
Practice Address - Street 1:637 N ALAMEDA BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2129
Practice Address - Country:US
Practice Address - Phone:505-526-4222
Practice Address - Fax:505-526-4228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM279251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN8388Medicaid
NMR13288Medicare UPIN