Provider Demographics
NPI:1417354739
Name:CAPALBO, KENDRA (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:KENDRA
Middle Name:
Last Name:CAPALBO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 THACHER ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-4917
Mailing Address - Country:US
Mailing Address - Phone:774-219-0943
Mailing Address - Fax:401-633-7396
Practice Address - Street 1:193 WATERMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4064
Practice Address - Country:US
Practice Address - Phone:774-219-0943
Practice Address - Fax:401-633-7396
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1222941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical