Provider Demographics
NPI:1316053705
Name:CAPAGE, JAMES EDWARD (PHD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:CAPAGE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4498
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26504-4498
Mailing Address - Country:US
Mailing Address - Phone:304-599-5073
Mailing Address - Fax:304-599-1955
Practice Address - Street 1:630 VISTA PLACES
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2363
Practice Address - Country:US
Practice Address - Phone:304-599-5073
Practice Address - Fax:304-599-1955
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV112103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV125310OtherCOMP PSYCH
WV4293759OtherAETNA
WVY319197OtherTHP
WV252787OtherCIGNA BEHAVIORAL HEALTH
WV252787OtherMAMSI- OPTIMUM CHOICE
WV5506874997211OtherCOMMUNITY INS. COMPANY
WV3810009613Medicaid
WV125310OtherMAGELLAN
WV125310OtherCOMP PSYCH
WV5506874997211OtherCOMMUNITY INS. COMPANY