MEDICARE: JAZMINE CAPEL LCSW SUPERVISEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0906017177	VA
2	1041S0200X	School Social Worker	0906017177	VA

General Provider Information

NPI Number	:	1144178542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZMINE CAPEL LCSW SUPERVISEE

Provider Business Mailing Address
First Line	:	6937 MINNIE AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23513-2951
Country	:	US
Telephone Number	:	757-238-0865
Fax Number	:

Provider Business Practice Location Address
First Line	:	6937 MINNIE AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23513-2951
Country	:	US
Telephone Number	:	757-238-0865
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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