Provider Demographics
NPI:1790043909
Name:CAPONE-SPRAGUE, ANDREW NEWTON (LMSW-CC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:NEWTON
Last Name:CAPONE-SPRAGUE
Suffix:
Gender:M
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GERRY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6103
Mailing Address - Country:US
Mailing Address - Phone:207-423-0099
Mailing Address - Fax:
Practice Address - Street 1:6 GERRY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6103
Practice Address - Country:US
Practice Address - Phone:207-423-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC132351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical