Provider Demographics
NPI:1487928347
Name:CAPONI, MICHELE M (NCC, LPC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:CAPONI
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:M
Other - Last Name:ACKERMAN CAPONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:518 BLACKTHORNE LANE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1005
Mailing Address - Country:US
Mailing Address - Phone:512-569-2199
Mailing Address - Fax:
Practice Address - Street 1:518 BLACKTHORNE LANE
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1005
Practice Address - Country:US
Practice Address - Phone:512-569-2199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66617101YP2500X
NY005397101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional