Provider Demographics
NPI:1528717667
Name:CAPELLO, CYANA ROSE
Entity type:Individual
Prefix:
First Name:CYANA
Middle Name:ROSE
Last Name:CAPELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 WILDLIFE LODGE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3652
Mailing Address - Country:US
Mailing Address - Phone:724-335-9733
Mailing Address - Fax:
Practice Address - Street 1:1600 WILDLIFE LODGE RD STE 1
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-3652
Practice Address - Country:US
Practice Address - Phone:724-335-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1371104OtherNATIONAL CERTIFIED COUNSELOR