Provider Demographics
NPI:1942991674
Name:CAPONE, GRACE (LSW)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:
Last Name:CAPONE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 NINETEEN NORTH CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5310
Mailing Address - Country:US
Mailing Address - Phone:724-840-5701
Mailing Address - Fax:
Practice Address - Street 1:5850 ELLSWORTH AVE STE 200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1775
Practice Address - Country:US
Practice Address - Phone:724-840-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136518104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker