=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316748965
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELLE CAP LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2025
-----------------------------------------------------
Last Update Date | 03/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 61 WALSINGHAM RD
-----------------------------------------------------
City | MENDHAM
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07945-1847
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-639-3361
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 SPOKANE LN
-----------------------------------------------------
City | BRANCHBURG
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08876-5447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-525-2913
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 37PC01074100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------