Provider Demographics
NPI:1447571740
Name:CAPUANO, KATHLEEN ROSENTHAL (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ROSENTHAL
Last Name:CAPUANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:ROSENTHAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:15 FARVIEW TER
Mailing Address - Street 2:2A
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2703
Mailing Address - Country:US
Mailing Address - Phone:201-747-1571
Mailing Address - Fax:201-845-4129
Practice Address - Street 1:15 FARVIEW TER
Practice Address - Street 2:2A
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2703
Practice Address - Country:US
Practice Address - Phone:201-747-1571
Practice Address - Fax:201-845-4129
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052757001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical