Provider Demographics
NPI:1336836295
Name:CAPPELLO, KAREN E (MSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:CAPPELLO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4322 SW JARMER RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-5634
Mailing Address - Country:US
Mailing Address - Phone:561-596-7299
Mailing Address - Fax:
Practice Address - Street 1:4322 SW JARMER RD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-5634
Practice Address - Country:US
Practice Address - Phone:561-596-7299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW159521041C0700X
FLSW215721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical