Provider Demographics
NPI:1083081434
Name:KATHLEEN J. CAPRONI, PHD, LICENSED PSYCHOLOGIST, PLLC
Entity Type:Organization
Organization Name:KATHLEEN J. CAPRONI, PHD, LICENSED PSYCHOLOGIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAPRONI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-260-9818
Mailing Address - Street 1:8 SUN CREEK LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:STONE RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12484-5639
Mailing Address - Country:US
Mailing Address - Phone:845-687-6341
Mailing Address - Fax:914-687-6341
Practice Address - Street 1:8 SUN CREEK LN
Practice Address - Street 2:SUITE 1
Practice Address - City:STONE RIDGE
Practice Address - State:NY
Practice Address - Zip Code:12484-5639
Practice Address - Country:US
Practice Address - Phone:845-687-6341
Practice Address - Fax:914-687-6341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012254-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11235593OtherCAQH