Provider Demographics
NPI:1235544289
Name:NELSON CRAIG, CASSANDRA D (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:D
Last Name:NELSON CRAIG
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 FAIRVIEW TER
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-3323
Mailing Address - Country:US
Mailing Address - Phone:317-721-5016
Mailing Address - Fax:
Practice Address - Street 1:1012 STAFFORD RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2228
Practice Address - Country:US
Practice Address - Phone:317-721-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-29
Last Update Date:2014-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN85000117A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist