Provider Demographics
NPI:1104045962
Name:MCNEIL-CAPERS, KIM MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:MARIE
Last Name:MCNEIL-CAPERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13922 232ND ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2927
Mailing Address - Country:US
Mailing Address - Phone:718-341-8862
Mailing Address - Fax:718-504-7774
Practice Address - Street 1:7559 263RD ST
Practice Address - Street 2:PSYCHIATRIC REHABILITATION
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1150
Practice Address - Country:US
Practice Address - Phone:718-470-8324
Practice Address - Fax:718-962-2742
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003071-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health