Provider Demographics
NPI:1376658179
Name:CAPACCHIONE, LINDA ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:CAPACCHIONE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 ROCKY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8560
Mailing Address - Country:US
Mailing Address - Phone:434-296-1338
Mailing Address - Fax:434-220-8628
Practice Address - Street 1:922 9 1/2 ST NE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5311
Practice Address - Country:US
Practice Address - Phone:434-296-1338
Practice Address - Fax:434-220-8628
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003585101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAM3190001OtherMAGELLAN HEALTH INSURANCE
VA114555OtherANTHEM HEALTH INSURANCE
VA0010052726Medicaid
VA7971307OtherAETNA INSURANCE
VA080956MOtherSENTARA SOUTHERN HEALTH