Provider Demographics
NPI:1386669141
Name:CAPPIELLO, THERESA (TERRY (LMHC)
Entity type:Individual
Prefix:
First Name:THERESA (TERRY
Middle Name:
Last Name:CAPPIELLO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 COLUMBIA ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3159
Mailing Address - Country:US
Mailing Address - Phone:360-696-2857
Mailing Address - Fax:360-737-0743
Practice Address - Street 1:110 COLUMBIA ST
Practice Address - Street 2:SUITE 115
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3159
Practice Address - Country:US
Practice Address - Phone:360-696-2857
Practice Address - Fax:360-737-0743
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALMHC00003731101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health