MEDICARE: CATHARINE CONNOR CAPUTO LPCC

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	101YP2500X	Professional Counselor	CCMH0214841	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CCMH0214841	OTHER	NM	NEW MEXICO COUNSELING AND THERAPY PRACTICE BOARD

General Provider Information

NPI Number	:	1679061683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHARINE CONNOR CAPUTO LPCC

Provider Business Mailing Address
First Line	:	223 N GUADALUPE ST UNIT 308
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-1868
Country	:	US
Telephone Number	:	505-660-5601
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 WASHINGTON AVE STE 267
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-2073
Country	:	US
Telephone Number	:	505-660-5601
Fax Number	:

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

Provider Enumeration Date	:	04/25/2018
Last Update Date	:	09/21/2021

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