Provider Demographics
NPI:1710644562
Name:CAPOVERDE, ELIZABETH (MA, LCDP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CAPOVERDE
Suffix:
Gender:F
Credentials:MA, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WESTERN HILLS LN APT 2302
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02921-1740
Mailing Address - Country:US
Mailing Address - Phone:401-808-7010
Mailing Address - Fax:
Practice Address - Street 1:154 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4469
Practice Address - Country:US
Practice Address - Phone:401-999-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00762101YA0400X
RIMHC01639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)