Provider Demographics
NPI:1588969604
Name:CAPEL, JASON (LCSW)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:CAPEL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 E WHITEKIRK WAY
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5609
Mailing Address - Country:US
Mailing Address - Phone:801-243-2540
Mailing Address - Fax:
Practice Address - Street 1:2156 E WHITEKIRK WAY
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5609
Practice Address - Country:US
Practice Address - Phone:801-243-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT259743-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical