Provider Demographics
NPI:1386528024
Name:CAPPELLI GORDON, MICHELLE LEA
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEA
Last Name:CAPPELLI GORDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 W ESTRELLA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-6008
Mailing Address - Country:US
Mailing Address - Phone:727-492-2048
Mailing Address - Fax:
Practice Address - Street 1:8081 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1029
Practice Address - Country:US
Practice Address - Phone:727-209-2666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health