Healthcare Provider Details

I. General information

NPI: 1104685023
Provider Name (Legal Business Name): JAMIE RAE CAPRI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 E MAIN ST
MOORESTOWN NJ
08057-3068
US

IV. Provider business mailing address

14 COOPER AVE APT B
EVESHAM NJ
08053-2173
US

V. Phone/Fax

Practice location:
  • Phone: 856-263-3416
  • Fax:
Mailing address:
  • Phone: 609-367-3057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06690700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: