Organization Active NPI

Jonna Marie Capio LMHC LLC

  • Counselor
  • Bloomington, IN
National Provider Identifier
1740789635
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
39002467A Issued in IN
Legal business name
JONNA MARIE CAPIO LMHC LLC
Practice address
3925 E Hagan St Ste 307
Bloomington, IN 47401-8649
Phone
(812) 331-7773
NPI assigned
Feb 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

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

Authorized official

Name
Jonna M Capio, LMHCNPI 1629383617
Title
Tin Owner
Phone
(812) 331-7773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 39002467A IN Primary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 39002467A IN

Addresses

Primary practice location

3925 E Hagan St Ste 307
Bloomington, IN 47401-8649

Mailing address

4972 E Heritage Woods Rd
Bloomington, IN 47401-9175
Phone (812) 331-7773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240426002290 IN Part B Supplier - Clinic/Group Practice 6103266929 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomington, IN

National Provider Directory

National Provider Directory

Locations

3925 E Hagan St
Ste 307
Bloomington, IN 47401
Phone (206) 853-5423

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517875200000",
    "number": "1740789635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4972 E HERITAGE WOODS RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474019175",
            "telephone_number": "812-331-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 E HAGAN ST STE 307",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018649",
            "telephone_number": "812-331-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONNA MARIE CAPIO LMHC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A",
        "authorized_official_last_name": "CAPIO",
        "authorized_official_first_name": "JONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "TIN OWNER",
        "authorized_official_telephone_number": "812-331-7773",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "IN",
            "license": "39002467A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002467A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.