Provider Demographics
NPI:1457065484
Name:CAPADAGLI, CATHERINE E (LMSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:E
Last Name:CAPADAGLI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:E
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1354 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-1480
Mailing Address - Country:US
Mailing Address - Phone:810-824-2567
Mailing Address - Fax:
Practice Address - Street 1:2186 WATER ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-2543
Practice Address - Country:US
Practice Address - Phone:810-966-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010903191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical