Provider Demographics
NPI:1033837695
Name:CASCARANO, CANDACE (LPC, CDAC)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:CASCARANO
Suffix:
Gender:F
Credentials:LPC, CDAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9520 MAYFIELD AVE APT N206
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2849
Mailing Address - Country:US
Mailing Address - Phone:708-372-9670
Mailing Address - Fax:
Practice Address - Street 1:9520 MAYFIELD AVE APT N206
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2849
Practice Address - Country:US
Practice Address - Phone:708-372-9670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
178.017639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health