Healthcare Provider Details

I. General information

NPI: 1174967251
Provider Name (Legal Business Name): CARA JANE CAPUANO MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARA JANE SAUNDERS

II. Dates (important events)

Enumeration Date: 04/19/2013
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 MACKLIND AVE
SAINT LOUIS MO
63110-1440
US

IV. Provider business mailing address

16216 BAXTER RD STE AND225
CHESTERFIELD MO
63017-4770
US

V. Phone/Fax

Practice location:
  • Phone: 314-534-0200
  • Fax:
Mailing address:
  • Phone: 636-532-9188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2007015778
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: