Provider Demographics
NPI:1760035570
Name:CAPOCCIA, ROSS (MA, LPC, CAADC)
Entity Type:Individual
Prefix:MR
First Name:ROSS
Middle Name:
Last Name:CAPOCCIA
Suffix:
Gender:M
Credentials:MA, LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MULBERRY ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1233
Mailing Address - Country:US
Mailing Address - Phone:570-955-5479
Mailing Address - Fax:570-955-5528
Practice Address - Street 1:1714 MAIN ST
Practice Address - Street 2:
Practice Address - City:BLAKELY
Practice Address - State:PA
Practice Address - Zip Code:18447-1362
Practice Address - Country:US
Practice Address - Phone:570-209-5981
Practice Address - Fax:570-489-1464
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-20
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011337101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor