Provider Demographics
NPI:1376225953
Name:ACAMPORA, CASSONDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:CASSONDRA
Middle Name:
Last Name:ACAMPORA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S CHERRY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3768
Mailing Address - Country:US
Mailing Address - Phone:203-675-5109
Mailing Address - Fax:
Practice Address - Street 1:673 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3149
Practice Address - Country:US
Practice Address - Phone:203-271-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT132231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical