Provider Demographics
NPI:1033265814
Name:CAPONE, ELLEN MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:MARIE
Last Name:CAPONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 S BRADDOCK ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4043
Mailing Address - Country:US
Mailing Address - Phone:540-678-0807
Mailing Address - Fax:540-678-0807
Practice Address - Street 1:214 S BRADDOCK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4043
Practice Address - Country:US
Practice Address - Phone:540-678-0807
Practice Address - Fax:540-678-0807
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904002375101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
088747OtherSENTARA-COMMUNITY HEALTH
085827OtherANTHEM-TRIGON
085827OtherANTHEM-TRIGON