Provider Demographics
NPI:1497203210
Name:CAPERS, MARJORIE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:CAPERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:
Other - Last Name:ROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:560 JACKSON ST N STE 302
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1449
Mailing Address - Country:US
Mailing Address - Phone:727-825-1479
Mailing Address - Fax:
Practice Address - Street 1:560 JACKSON ST N STE 302
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1449
Practice Address - Country:US
Practice Address - Phone:727-825-1479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11859101YM0800X
FLSW185921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health