Provider Demographics
NPI:1376313114
Name:CAPRI, KASEY
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:CAPRI
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 1:930 SPOTSWOOD AVE
Mailing Address - Street 2:APT D5
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1734
Mailing Address - Country:US
Mailing Address - Phone:757-264-0085
Mailing Address - Fax:
Practice Address - Street 1:930 SPOTSWOOD AVE
Practice Address - Street 2:APT D5
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1734
Practice Address - Country:US
Practice Address - Phone:757-264-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1061046106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician