Individual
RALPH MICHAEL CAPTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 ELIZABETH PL, DAYTON, OH 45417-3445
(937) 520-4800
Mailing address
PO BOX 212, XENIA, OH 45385-0212
(937) 708-8348
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.186820
OH
175T00000X
Peer Specialist
Primary
APS.003572
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APS.003572
STATE OF OHIO MENTAL HEALTH AND ADDICTION SERVICES
OH
Enumeration date
10/30/2023
Last updated
06/17/2024
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