Charles Capicchioni, M.A.L.L.P.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

6301012712 Issued in MI

Practice address

29260 Franklin Rd
Southfield, MI 48034-1161

Phone

(248) 355-4300

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427255355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 HIDDEN HBR",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483902111",
            "telephone_number": "248-470-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29260 FRANKLIN RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341161",
            "telephone_number": "248-355-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPICCHIONI",
        "first_name": "CHARLES",
        "credential": "M.A.L.L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301012712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Halil Ibrahim Canter, M.D.
• Broden Charles Cantu I
• Nancy Jingyang Cao, MD, PHD
• Ana Maria Madalina Capatina-Rata, M.D.
• Haley Capel, LLMSW
• Dawn Lyn Capizzo, LMSW
• Bree Cappon
• Theresa Carano, L.P.C.
• Chelsea Carbajal
• Tanaija Carbin, NP

• Clinical Child & Adolescent Psychologist in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Child & Adolescent Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.