Basic Information
| Provider Information | |||||||||
| NPI: | 1326254145 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAPURRO | ||||||||
| FirstName: | DALE | ||||||||
| MiddleName: | HOWARD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 BOBCAT CIR | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897039465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758822444 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1001 MOUNTAIN ST | ||||||||
| Address2: | SUITE 3-H | ||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897033848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7754457768 | ||||||||
| FaxNumber: | 7758410304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2007 | ||||||||
| LastUpdateDate: | 12/09/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 00116-C | NV | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.