Healthcare Provider Details

I. General information

NPI: 1710258207
Provider Name (Legal Business Name): LAURA E CAPEL MA, NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2012
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 MARKET ST
WILLIAMSPORT PA
17701-3402
US

IV. Provider business mailing address

811 MARKET ST
WILLIAMSPORT PA
17701-3402
US

V. Phone/Fax

Practice location:
  • Phone: 570-433-0249
  • Fax:
Mailing address:
  • Phone: 570-433-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC008788
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: