MEDICARE: CYANA ROSE CAPELLO

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	101YP2500X	Professional Counselor	PC014313	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1371104	OTHER	PA	NATIONAL CERTIFIED COUNSELOR

General Provider Information

NPI Number	:	1528717667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYANA ROSE CAPELLO

Provider Business Mailing Address
First Line	:	1600 WILDLIFE LODGE RD STE 1
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-3652
Country	:	US
Telephone Number	:	724-335-9733
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 WILDLIFE LODGE RD STE 1
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-3652
Country	:	US
Telephone Number	:	724-335-9733
Fax Number	:

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

Provider Enumeration Date	:	03/23/2022
Last Update Date	:	04/24/2025

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Directions to “ CYANA ROSE CAPELLO ” Practice Location

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