Provider Demographics
NPI:1437359130
Name:CASSIUS, JEREMY (LPC)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:CASSIUS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 SPRING VALLEY RD STE 275
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-3629
Mailing Address - Country:US
Mailing Address - Phone:214-830-8214
Mailing Address - Fax:866-242-3378
Practice Address - Street 1:4100 SPRING VALLEY RD STE 275
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-3629
Practice Address - Country:US
Practice Address - Phone:214-830-8214
Practice Address - Fax:866-242-3378
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2017-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX65426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health