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General NPI Number Information
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NPI Number | 1467895755
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Entity Type | Individual
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Provider Name | KIMBERLY CAPPELLANO
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Gender | Female
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 1410 E GOLD COAST RD STE 700
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City | PAPILLION
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State | NE
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Zip | 68046-5841
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Country | US
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Telephone | 402-237-6415
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Fax |
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Provider Business Mailing Address
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Address Line | 20275 HONEYSUCKLE DR SUITE 103
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City | ELKHORN
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State | NE
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Zip | 68022-3962
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Country | US
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Telephone | 402-933-5700
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Fax | 402-933-9998
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9940
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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