Provider Demographics
NPI:1083095715
Name:CAPPETTO, MICHELLE (MAED, MFT, LPC-CR)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:CAPPETTO
Suffix:
Gender:F
Credentials:MAED, MFT, LPC-CR
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:CAPPETTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MAED, MFT, LPC-CR
Mailing Address - Street 1:30701 LORAIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-6325
Mailing Address - Country:US
Mailing Address - Phone:440-274-5035
Mailing Address - Fax:
Practice Address - Street 1:20575 CENTER RIDGE RD STE 318
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3422
Practice Address - Country:US
Practice Address - Phone:216-563-1661
Practice Address - Fax:833-252-6406
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1300185-CR101Y00000X
OHM. 1400011106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor