Provider Demographics
NPI:1356887665
Name:CAPPABIANCO, CHRISTOPHER (M ED, BSL)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CAPPABIANCO
Suffix:
Gender:M
Credentials:M ED, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N. 6TH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17102
Mailing Address - Country:US
Mailing Address - Phone:717-560-7917
Mailing Address - Fax:
Practice Address - Street 1:900 N 6TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102
Practice Address - Country:US
Practice Address - Phone:717-233-2047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health