Provider Demographics
NPI:1174038582
Name:CAPLE, JENNIFER JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JANE
Last Name:CAPLE
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 1:317 DEINHARD LANE
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638
Mailing Address - Country:US
Mailing Address - Phone:208-315-0272
Mailing Address - Fax:208-405-2770
Practice Address - Street 1:317 DEINHARD LN
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638-4703
Practice Address - Country:US
Practice Address - Phone:208-405-2770
Practice Address - Fax:208-475-6422
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-363651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDLCSW-36365OtherSOCIAL WORK LICENSE