Provider Demographics
NPI:1831223155
Name:CAPONE, VINCENT M (MSW)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:M
Last Name:CAPONE
Suffix:
Gender:M
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:PO BOX 8342
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002
Mailing Address - Country:US
Mailing Address - Phone:856-414-9003
Mailing Address - Fax:856-414-0059
Practice Address - Street 1:1060 KINGS HWY N
Practice Address - Street 2:SUITE 309
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1910
Practice Address - Country:US
Practice Address - Phone:856-414-9003
Practice Address - Fax:856-414-0059
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC 052598001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0018881Medicaid
NJ60054OtherAETNA GROUP
NH2317447000OtherIBC AMERIHEALTH
NJ1285770479OtherGROUP NPI
NJ589714000OtherMAGELLAN GROUP