Provider Demographics
NPI:1710945407
Name:CAPLER, JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:CAPLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S ROGERS ST
Mailing Address - Street 2:SUITE #4
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-4934
Mailing Address - Country:US
Mailing Address - Phone:812-331-8244
Mailing Address - Fax:812-331-8249
Practice Address - Street 1:118 S ROGERS ST
Practice Address - Street 2:SUITE #4
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-4934
Practice Address - Country:US
Practice Address - Phone:812-331-8244
Practice Address - Fax:812-331-8249
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN340045101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN06229OtherSIHO PROVIDER NUMBER
IN385904OtherANTHEM PROVIDER NUMBER
IN11489761OtherCAQH PROVIDER NUMBER
IN06229OtherSIHO PROVIDER NUMBER