Provider Demographics
NPI:1437324993
Name:CAPACHIONE, JOHN DOMENIC (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DOMENIC
Last Name:CAPACHIONE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 HODGSON MEMORIAL DR
Mailing Address - Street 2:STE. D
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2568
Mailing Address - Country:US
Mailing Address - Phone:912-352-8801
Mailing Address - Fax:912-352-9556
Practice Address - Street 1:1100 BRAMPTON AVE STE N
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-0871
Practice Address - Country:US
Practice Address - Phone:912-266-9094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004074101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional