Provider Demographics
NPI:1548345671
Name:CAPPS, FREDERICK (PHD, LPC)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:
Last Name:CAPPS
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 S PADRE ISLAND DR STE 105
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5128
Mailing Address - Country:US
Mailing Address - Phone:361-857-6653
Mailing Address - Fax:361-857-8013
Practice Address - Street 1:4455 S PADRE ISLAND DR STE 105
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5128
Practice Address - Country:US
Practice Address - Phone:361-857-6653
Practice Address - Fax:361-857-8013
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13690101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3436LCOtherBLUECROSS/BLUESHIELD