=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821950791
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KRISTI CAPPAERT LISW, LCSW
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2025
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2435 KIMBERLY RD STE 10N
-----------------------------------------------------
City | BETTENDORF
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52722-3572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-235-6605
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2435 KIMBERLY RD STE 10N
-----------------------------------------------------
City | BETTENDORF
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52722-3572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-235-6605
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED INDEPENDENT SOCIAL WORKER
-----------------------------------------------------
Name | MRS. KRISTILEE CARYL CAPPAERT
-----------------------------------------------------
Credential | LISW, LCSW
-----------------------------------------------------
Telephone | 309-235-6605
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------