Provider Demographics
NPI:1043487390
Name:CAPERTON, BRENDA LEE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LEE
Last Name:CAPERTON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1893
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:NM
Mailing Address - Zip Code:88231-1893
Mailing Address - Country:US
Mailing Address - Phone:575-631-5130
Mailing Address - Fax:
Practice Address - Street 1:809 E TEXAS AVE
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:NM
Practice Address - Zip Code:88231-3888
Practice Address - Country:US
Practice Address - Phone:575-631-5130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0134431101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000463000Medicaid