Healthcare Provider Details

I. General information

NPI: 1265004980
Provider Name (Legal Business Name): CAPUTO COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 08/01/2021
Certification Date: 08/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 WASHINGTON AVE STE 267
SANTA FE NM
87501-2073
US

IV. Provider business mailing address

223 N GUADALUPE ST # 308
SANTA FE NM
87501-1868
US

V. Phone/Fax

Practice location:
  • Phone: 505-660-5601
  • Fax:
Mailing address:
  • Phone: 505-660-5601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHARINE CONNOR CAPUTO
Title or Position: MEMBER
Credential: LPCC
Phone: 505-660-5601