Basic Information
| Provider Information | |||||||||
| NPI: | 1124359641 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAPUTO | ||||||||
| FirstName: | ADRIANA | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2130 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 814013834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702523200 | ||||||||
| FaxNumber: | 9702523208 | ||||||||
| Practice Location | |||||||||
| Address1: | 710 N TAYLOR ST | ||||||||
| Address2: | |||||||||
| City: | GUNNISON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706410229 | ||||||||
| FaxNumber: | 9706412949 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2010 | ||||||||
| LastUpdateDate: | 06/06/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | T-0127501 | NM | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | LPC0013896 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.