Provider Demographics
NPI:1821625856
Name:KAPELSON, BENJAMIN D (LADC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:D
Last Name:KAPELSON
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 EMERY ST # B
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-2316
Mailing Address - Country:US
Mailing Address - Phone:603-557-4993
Mailing Address - Fax:
Practice Address - Street 1:51 EMERY ST # B
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2316
Practice Address - Country:US
Practice Address - Phone:603-557-4993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC6885101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health