Provider Demographics
NPI:1043488349
Name:MCCUNE, KASSANDRA SHUGARS (LMHC)
Entity Type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:SHUGARS
Last Name:MCCUNE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-2746
Mailing Address - Country:US
Mailing Address - Phone:904-392-9188
Mailing Address - Fax:
Practice Address - Street 1:88 RIBERIA STREET
Practice Address - Street 2:SUITE 150
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084
Practice Address - Country:US
Practice Address - Phone:904-392-9188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor