Provider Demographics
NPI:1073932117
Name:KESTER, CASSANDRA M (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:M
Last Name:KESTER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13022
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88013-3022
Mailing Address - Country:US
Mailing Address - Phone:575-888-7467
Mailing Address - Fax:
Practice Address - Street 1:1800 AVENIDA DE MESILLA STE D
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3920
Practice Address - Country:US
Practice Address - Phone:575-888-7467
Practice Address - Fax:575-233-6324
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0183471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM79075321Medicaid