Provider Demographics
NPI:1376181883
Name:CAPPAERT, KRISTILEE CARYL
Entity Type:Individual
Prefix:MRS
First Name:KRISTILEE
Middle Name:CARYL
Last Name:CAPPAERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 KIMBERLY RD SUITE 10N
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-2033
Mailing Address - Country:US
Mailing Address - Phone:092-356-6053
Mailing Address - Fax:
Practice Address - Street 1:1910 E KIMBERLY RD STE 314
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2033
Practice Address - Country:US
Practice Address - Phone:563-386-4004
Practice Address - Fax:563-386-4026
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA008203101YP2500X
IL149.021037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional