Provider Demographics
NPI:1750541405
Name:PAMELA CAPPETTA ED D PC
Entity type:Organization
Organization Name:PAMELA CAPPETTA ED D PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:G
Authorized Official - Last Name:CAPPETTA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:757-253-5708
Mailing Address - Street 1:362 MCLAWS CIR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5648
Mailing Address - Country:US
Mailing Address - Phone:757-253-5708
Mailing Address - Fax:757-253-6535
Practice Address - Street 1:362 MCLAWS CIR
Practice Address - Street 2:SUITE 2
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5648
Practice Address - Country:US
Practice Address - Phone:757-253-5708
Practice Address - Fax:757-253-6535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
VA0717000489106H00000X
VA0701001146101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty