Provider Demographics
NPI:1710030721
Name:CAPPS ASSESSMENT PSYCHOLOGICAL & PSYCHO-EDUCATIONAL SERVICES, PLC
Entity Type:Organization
Organization Name:CAPPS ASSESSMENT PSYCHOLOGICAL & PSYCHO-EDUCATIONAL SERVICES, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CAPPS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:313-213-6377
Mailing Address - Street 1:20816 E 11 MILE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1565
Mailing Address - Country:US
Mailing Address - Phone:313-213-6377
Mailing Address - Fax:313-821-8392
Practice Address - Street 1:20816 E 11 MILE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1565
Practice Address - Country:US
Practice Address - Phone:313-213-6377
Practice Address - Fax:313-821-8392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
MI6301008488103TC0700X
MI68010623461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI68-0-EO-1849-0OtherPIN