1073568937 NPI number — JUDITH G. CAPLAN,LCSW,CSAC,LLC

Table of content: (NPI 1073568937)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073568937 NPI number — JUDITH G. CAPLAN,LCSW,CSAC,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JUDITH G. CAPLAN,LCSW,CSAC,LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
INTEGRATED HEALTH ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073568937
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 BREMO RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23226-2440
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-288-1337
Provider Business Mailing Address Fax Number:
804-288-0277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 BREMO RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23226-2440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-288-1337
Provider Business Practice Location Address Fax Number:
804-288-0277
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CAPLAN
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
G.
Authorized Official Title or Position:
SOLE MEMBER
Authorized Official Telephone Number:
804-288-1337

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  0710001228 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X , with the licence number: 0904003258 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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