Provider Demographics
NPI:1700169661
Name:CAPOBIANCO, CLAIRE (LCSW)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:CAPOBIANCO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11585 JONES BRIDGE RD STE
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-7476
Mailing Address - Country:US
Mailing Address - Phone:678-680-8858
Mailing Address - Fax:
Practice Address - Street 1:5435 SUGARLOAF PKWY STE 1102
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5700
Practice Address - Country:US
Practice Address - Phone:678-680-8858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0053181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical