Provider Demographics
NPI:1104395888
Name:CASKEY, CLARISSA A (MA, LPC-A)
Entity Type:Individual
Prefix:MRS
First Name:CLARISSA
Middle Name:A
Last Name:CASKEY
Suffix:
Gender:F
Credentials:MA, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7472 WATERSIDE LOOP RD
Mailing Address - Street 2:#114
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-9240
Mailing Address - Country:US
Mailing Address - Phone:980-222-4788
Mailing Address - Fax:
Practice Address - Street 1:7472 WATERSIDE LOOP RD
Practice Address - Street 2:#114
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-9240
Practice Address - Country:US
Practice Address - Phone:980-222-4788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-25
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13225101YP2500X
NC13225101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty