Healthcare Provider Details

I. General information

NPI: 1598628240
Provider Name (Legal Business Name): LAUREL CAPLAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 W UNIVERSITY AVE APT 405
FLAGSTAFF AZ
86001-7107
US

IV. Provider business mailing address

813 W UNIVERSITY AVE APT 405
FLAGSTAFF AZ
86001-7107
US

V. Phone/Fax

Practice location:
  • Phone: 781-752-9120
  • Fax:
Mailing address:
  • Phone: 781-752-9120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: