Provider Demographics
NPI:1841454386
Name:CAPITANO, STEPHEN (LMHC, CASAC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:CAPITANO
Suffix:
Gender:M
Credentials:LMHC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BLUE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11715-2108
Mailing Address - Country:US
Mailing Address - Phone:631-363-8327
Mailing Address - Fax:
Practice Address - Street 1:2 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:BLUE POINT
Practice Address - State:NY
Practice Address - Zip Code:11715-2108
Practice Address - Country:US
Practice Address - Phone:631-363-8327
Practice Address - Fax:631-363-8327
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10537101YA0400X
NY001805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)