Provider Demographics
NPI:1194265470
Name:CAPRERA, PAUL M (LMHC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:CAPRERA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1230
Mailing Address - Country:US
Mailing Address - Phone:518-439-0033
Mailing Address - Fax:518-439-7167
Practice Address - Street 1:196 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1230
Practice Address - Country:US
Practice Address - Phone:518-439-0033
Practice Address - Fax:518-439-7167
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health