Healthcare Provider Details

I. General information

NPI: 1497624050
Provider Name (Legal Business Name): CAPABLE KIDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2722 N HOLLAND SYLVANIA RD
TOLEDO OH
43615-1823
US

IV. Provider business mailing address

2722 N HOLLAND SYLVANIA RD
TOLEDO OH
43615-1823
US

V. Phone/Fax

Practice location:
  • Phone: 419-346-8269
  • Fax: 419-843-2962
Mailing address:
  • Phone: 419-346-8269
  • Fax: 419-843-2962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: HEATHER NICOLE BEAM
Title or Position: EXECUTIVE DIRECTOR
Credential: M.ED., BCBA, COBA
Phone: 419-346-8269