Provider Demographics
NPI:1710654645
Name:CAPRON, CASEY ROSE (LPCC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:ROSE
Last Name:CAPRON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:ROSE
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 ACADIA AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1845
Mailing Address - Country:US
Mailing Address - Phone:303-478-0030
Mailing Address - Fax:
Practice Address - Street 1:222 ACADIA AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-1845
Practice Address - Country:US
Practice Address - Phone:303-478-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18529101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0018529OtherDEPARTMENT OF REGULATORY AGENCIES