Individual
CAPEN SHAYNE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4420 DELESPINE RD, COCOA, FL 32927-3552
(321) 795-6818
Mailing address
4420 DELESPINE RD, COCOA, FL 32927-3552
(321) 795-6818
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
PO17106
NC
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/04/2017
Last updated
10/17/2022
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