Provider Demographics
NPI:1336681493
Name:DICKMANN, CASSIE ROSE (MED, LPC)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:ROSE
Last Name:DICKMANN
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 N 3RD ST
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-2044
Mailing Address - Country:US
Mailing Address - Phone:717-531-4100
Mailing Address - Fax:717-531-0770
Practice Address - Street 1:2626 N 3RD ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-2044
Practice Address - Country:US
Practice Address - Phone:717-531-4100
Practice Address - Fax:717-531-0770
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008969101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional