Provider Demographics
NPI:1760016018
Name:CAPITAL PRIVATE PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:CAPITAL PRIVATE PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LSW, MBA-HCA
Authorized Official - Phone:614-364-6206
Mailing Address - Street 1:4369 OAKS SHADOW DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-5001
Mailing Address - Country:US
Mailing Address - Phone:614-364-6206
Mailing Address - Fax:
Practice Address - Street 1:4369 OAKS SHADOW DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-5001
Practice Address - Country:US
Practice Address - Phone:614-364-6206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty