Healthcare Provider Details

I. General information

NPI: 1295644151
Provider Name (Legal Business Name): CAROLINE ELISE CAPELLUPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6421 CORBLY RD
CINCINNATI OH
45230-1437
US

IV. Provider business mailing address

PO BOX 5381
CINCINNATI OH
45201-5381
US

V. Phone/Fax

Practice location:
  • Phone: 513-363-5000
  • Fax:
Mailing address:
  • Phone: 513-363-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.03327
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: