Provider Demographics
NPI:1609391168
Name:CAPECE, AMANDA ELIZABETH (QS-LMHC, EDS, MS)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:CAPECE
Suffix:
Gender:F
Credentials:QS-LMHC, EDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 E PARK AVE STE I100
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2600
Mailing Address - Country:US
Mailing Address - Phone:850-765-6769
Mailing Address - Fax:850-270-6932
Practice Address - Street 1:820 E PARK AVE STE I100
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2600
Practice Address - Country:US
Practice Address - Phone:850-765-6769
Practice Address - Fax:850-270-6932
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-06
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14628101YP2500X, 101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor