Healthcare Provider Details

I. General information

NPI: 1104128172
Provider Name (Legal Business Name): CAPITAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2010
Last Update Date: 11/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 CALLE ANTONIO R BARC
ARECIBO PR
00612-4529
US

IV. Provider business mailing address

PO BOX 571
ARECIBO PR
00613-0571
US

V. Phone/Fax

Practice location:
  • Phone: 787-816-1256
  • Fax: 787-878-5778
Mailing address:
  • Phone: 787-816-1256
  • Fax: 787-878-5778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2683
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3159
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2718
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1391
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8030
License Number StatePR
# 7
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: RITA JAMES
Title or Position: CLINICAL DIRECTOR
Credential: M.A.
Phone: 787-816-1256