Basic Information
| Provider Information | |||||||||
| NPI: | 1447715230 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAPITA | ||||||||
| FirstName: | HELEN | ||||||||
| MiddleName: | SANDRA | ||||||||
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| Credential: | MS, LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3623 EGGERT RD STE 204 | ||||||||
| Address2: | |||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141271947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163241586 | ||||||||
| FaxNumber: | 7168193430 | ||||||||
| Practice Location | |||||||||
| Address1: | 3623 EGGERT RD STE 204 | ||||||||
| Address2: | |||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141271947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163241586 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2019 | ||||||||
| LastUpdateDate: | 02/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 011682-01 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.