Provider Demographics
NPI:1003080888
Name:CASSAR, JOSEPHINE CARMEL (LMSW, SSW, LMFT)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:CARMEL
Last Name:CASSAR
Suffix:
Gender:F
Credentials:LMSW, SSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-6753
Mailing Address - Country:US
Mailing Address - Phone:269-926-6199
Mailing Address - Fax:269-926-6780
Practice Address - Street 1:1850 COLFAX AVE
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-6753
Practice Address - Country:US
Practice Address - Phone:269-926-6199
Practice Address - Fax:269-926-6780
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010169201041C0700X
MI4101005789106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist