Provider Demographics
NPI:1447591425
Name:CARDINALE, KASEY MARIE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:MARIE
Last Name:CARDINALE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4832 AMERICAN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6212
Mailing Address - Country:US
Mailing Address - Phone:916-717-1420
Mailing Address - Fax:
Practice Address - Street 1:193 BLUE RAVINE RD
Practice Address - Street 2:#220
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4756
Practice Address - Country:US
Practice Address - Phone:916-988-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49434106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist