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General NPI Number Information
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NPI Number | 1730189721
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Entity Type | Individual
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Provider Name | SUSAN CAPUTO LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/31/2005
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Last Update Date | 07/27/2014
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Provider Practice Location Address
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Address Line | 257 15TH ST SUITE 203
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City | BROOKLYN
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State | NY
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Zip | 11215-4988
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Country | US
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Telephone | 917-678-4628
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 E 12TH ST
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City | BROOKLYN
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State | NY
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Zip | 11229-4104
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Country | US
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Telephone | 718-339-8258
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R063704-1
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License Number State | NY
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