Provider Demographics
NPI:1326813122
Name:CASCONE, GRACE C (MS, LCMHCA)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:C
Last Name:CASCONE
Suffix:
Gender:F
Credentials:MS, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E CAMA ST APT 252
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-1793
Mailing Address - Country:US
Mailing Address - Phone:229-977-5499
Mailing Address - Fax:
Practice Address - Street 1:17015 KENTON DR STE 203
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5561
Practice Address - Country:US
Practice Address - Phone:980-689-0280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health