MEDICARE: DAVID THOMAS CAPARRELLI JR. LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	120651	MA

General Provider Information

NPI Number	:	1255840146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID THOMAS CAPARRELLI JR. LICSW

Provider Business Mailing Address
First Line	:	115 PARK ST APT 10
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-4921
Country	:	US
Telephone Number	:	413-770-1482
Fax Number	:

Provider Business Practice Location Address
First Line	:	266 BEACON ST STE 4
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02116-1288
Country	:	US
Telephone Number	:	413-770-1482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2017
Last Update Date	:	09/24/2017

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