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General NPI Number Information
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NPI Number | 1922468966
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Entity Type | Individual
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Provider Name | LAURA CAPOCCIA M.S.W, L.S.W
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Gender | Female
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 28 MILLBURN AVENUE
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City | SPRINGFIELD
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State | NJ
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Zip | 07081
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Country | US
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Telephone | 908-405-4302
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Fax |
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Provider Business Mailing Address
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Address Line | 28 MILLBURN AVE
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1039
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Country | US
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Telephone |
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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 | 44SL06155700
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License Number State | NJ
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