Healthcare Provider Details

I. General information

NPI: 1336986546
Provider Name (Legal Business Name): VALERIA CAPOZZI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 CLARK TER
CLIFFSIDE PARK NJ
07010-1436
US

IV. Provider business mailing address

249 CLARK TER
CLIFFSIDE PARK NJ
07010-1436
US

V. Phone/Fax

Practice location:
  • Phone: 201-658-5601
  • Fax:
Mailing address:
  • Phone: 201-658-5601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00750700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: