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General NPI Number Information
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NPI Number | 1619440179
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Entity Type | Individual
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Provider Name | JOHN CAPPELLO MA
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Gender | Male
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 218 E CHELSEA CIR
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-2108
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Country | US
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Telephone | 610-805-0512
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Fax |
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Provider Business Mailing Address
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Address Line | 301 JEFFREY LN
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-2507
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Country | US
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Telephone | 610-805-0512
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC015291
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License Number State | PA
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