Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker | |
Psychiatry |
2084P0800X | 26 | Physician/Psychiatry |
| NPI Number | 1639593080 |
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| LBN Legal business name | CAPITOL COUNSELING, LLC | ||||||||||||||||||||||||||||||||||||
| Authorized official | SUSAN WRIEDT-BYRNE - (PARTNER) | ||||||||||||||||||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||||||||||||||||||||||
| Enumeration date | 02/05/2014 | ||||||||||||||||||||||||||||||||||||
| Last updated | 01/20/2015 - About 11 years ago | ||||||||||||||||||||||||||||||||||||
| Identifiers |
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