Provider Demographics
NPI:1245390103
Name:CAPRONI, KATHLEEN JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:JEAN
Last Name:CAPRONI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
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:914-260-9818
Mailing Address - Fax:845-256-0432
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:914-260-9818
Practice Address - Fax:845-256-0432
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012254103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11235593OtherCAQH