Healthcare Provider Details

I. General information

NPI: 1033922992
Provider Name (Legal Business Name): MR. ANTHONY B CAPRARA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 09/11/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 BURTON ST SE STE 210
GRAND RAPIDS MI
49506-4669
US

IV. Provider business mailing address

1635 E 13 MILE RD APT 302
MADISON HEIGHTS MI
48071-5024
US

V. Phone/Fax

Practice location:
  • Phone: 616-236-3600
  • Fax:
Mailing address:
  • Phone: 616-406-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: