Healthcare Provider Details

I. General information

NPI: 1205459773
Provider Name (Legal Business Name): MICAELA CAPLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MIDDLESEX TPKE STE 107
BEDFORD MA
01730-1436
US

IV. Provider business mailing address

165 MIDDLESEX TPKE STE 107
BEDFORD MA
01730-1436
US

V. Phone/Fax

Practice location:
  • Phone: 781-604-3793
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: