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General NPI Number Information
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NPI Number | 1437324993
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Entity Type | Individual
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Provider Name | JOHN DOMENIC CAPACHIONE LPC
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Gender | Male
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 1100 BRAMPTON AVE STE N
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City | STATESBORO
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State | GA
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Zip | 30458-0871
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Country | US
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Telephone | 912-266-9094
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Fax |
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Provider Business Mailing Address
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Address Line | 7025 HODGSON MEMORIAL DR STE. D
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City | SAVANNAH
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State | GA
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Zip | 31406-2568
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Country | US
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Telephone | 912-352-8801
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Fax | 912-352-9556
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC004074
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License Number State | GA
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