Provider Demographics
NPI:1821798687
Name:KAPTAIN COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:KAPTAIN COUNSELING AND CONSULTING
Other - Org Name:CITYREACH FAMILY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAPTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT, CADC
Authorized Official - Phone:515-277-2489
Mailing Address - Street 1:6202 SILVER BIRCH CT
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-7601
Mailing Address - Country:US
Mailing Address - Phone:515-490-8870
Mailing Address - Fax:
Practice Address - Street 1:5801 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50322-6131
Practice Address - Country:US
Practice Address - Phone:515-490-8870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty