Colleen Anne Capezzuto, LICENSED SCHOOL PSY

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

SS1538 Issued in FL

Practice address

184 Oak Common Ave
St Augustine, FL 32095-6805

Phone

(904) 907-7489

NPI assigned

Nov 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1760190052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 OAK COMMON AVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320956805",
            "telephone_number": "904-907-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 OAK COMMON AVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320956805",
            "telephone_number": "904-907-7489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPEZZUTO",
        "first_name": "COLLEEN",
        "middle_name": "ANNE",
        "credential": "LICENSED SCHOOL PSY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "SS1538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Lynn Cannan
• Aubrey Cannata
• Jennifer Cannon, BSHS, LMT
• Amanda M Capel, R.N., B.S.N.
• Marla Ruth Capes, APRN
• Susan Patricia Capitano, MS, LMHC
• Alexis Rae Capria
• Richard A Caputo, M.D.
• Ernesto J. Carames, M.D.
• Carol Mehlberg Carberry, BA

• Counseling Psychologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.