MEDICARE: LAUREL CAPLAN

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	101YM0800X	Mental Health Counselor		AZ

General Provider Information

NPI Number	:	1598628240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREL CAPLAN

Provider Business Mailing Address
First Line	:	813 W UNIVERSITY AVE APT 405
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-7107
Country	:	US
Telephone Number	:	781-752-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	813 W UNIVERSITY AVE APT 405
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-7107
Country	:	US
Telephone Number	:	781-752-9120
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ LAUREL CAPLAN ” Practice Location

Language	Start Address	Practice Location

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