Provider Demographics
NPI:1598509028
Name:CAPRARI, SHANNON PARLETT (PCMHT)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:PARLETT
Last Name:CAPRARI
Suffix:
Gender:F
Credentials:PCMHT
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:GRACE
Other - Last Name:PARLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCMHT
Mailing Address - Street 1:7941 CASTLEWAY DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1953
Mailing Address - Country:US
Mailing Address - Phone:228-760-1160
Mailing Address - Fax:
Practice Address - Street 1:9414 THREE RIVERS RD STE 3
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3861
Practice Address - Country:US
Practice Address - Phone:228-760-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health