MEDICARE: CAPUTO COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1265004980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPUTO COUNSELING LLC

Provider Business Mailing Address
First Line	:	223 N GUADALUPE ST # 308
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-1868
Country	:	US
Telephone Number	:	505-660-5601
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 WASHINGTON AVE STE 267
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-2073
Country	:	US
Telephone Number	:	505-660-5601
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	CATHARINE CONNOR CAPUTO
Credential	:	LPCC
Telephone Number	:	505-660-5601

Provider Enumeration Date	:	07/13/2021
Last Update Date	:	08/01/2021

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