Provider Demographics
NPI:1790182889
Name:CAPPITTE, STACY LYNN (OTA)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:LYNN
Last Name:CAPPITTE
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 LUCERNE LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-3419
Mailing Address - Country:US
Mailing Address - Phone:330-277-6129
Mailing Address - Fax:
Practice Address - Street 1:918 YOUNGSTOWN WARREN RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4623
Practice Address - Country:US
Practice Address - Phone:330-505-1606
Practice Address - Fax:330-505-2621
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.05555225X00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist