Individual provider Active NPI

Mary Frances Capitena-Bento, LICDC-CS

  • Clinical Social Worker
  • Rock Creek, OH
National Provider Identifier
1134740269
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.2208294 Issued in OH
Practice address
2863 State Route 45 N
Rock Creek, OH 44084-9352
Phone
(440) 563-3400
Fax
(440) 563-3528
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.943954 OH
Clinical Social Worker 1041C0700X S.2208294 OH Primary

Addresses

Primary practice location

2863 State Route 45 N
Rock Creek, OH 44084-9352

Mailing address

2863 State Route 45 N
Rock Creek, OH 44084-9352
Phone (440) 563-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.943954OHMDAddiction (Substance Use Disorder) Counselor
S.2208294OHMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1134740269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2863 STATE ROUTE 45 N",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440849352",
            "telephone_number": "440-563-3400",
            "fax_number": "440-563-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 STATE ROUTE 45 N",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440849352",
            "telephone_number": "440-563-3400",
            "fax_number": "440-563-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPITENA-BENTO",
        "first_name": "MARY",
        "middle_name": "FRANCES",
        "credential": "LICDC-CS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.943954",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2208294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Creek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.