Provider Demographics
NPI:1659009033
Name:CAPESIUS, BRIANNA (MED)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:CAPESIUS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:SUKENIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1508 NEW PINERY RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:WI
Mailing Address - Zip Code:53901-1312
Mailing Address - Country:US
Mailing Address - Phone:608-745-4900
Mailing Address - Fax:
Practice Address - Street 1:1508 NEW PINERY RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:WI
Practice Address - Zip Code:53901-1312
Practice Address - Country:US
Practice Address - Phone:608-745-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health