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General NPI Number Information
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NPI Number | 1497961981
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Entity Type | Individual
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Provider Name | CAROL L CAPTAIN CAROL CAPTAIN, LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 7481 W OAKLAND PARK BLVD STE 308
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City | TAMARAC
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State | FL
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Zip | 33319-4961
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Country | US
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Telephone | 954-465-5544
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Fax |
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Provider Business Mailing Address
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Address Line | 8081 PALMETTO PALM CIR
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City | TAMARAC
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State | FL
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Zip | 33321-2729
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Country | US
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Telephone | 954-465-5544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2680
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT1975
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License Number State | FL
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