Provider Demographics
NPI:1457490633
Name:KASSEES, JOANNE M
Entity Type:Individual
Prefix:MISS
First Name:JOANNE
Middle Name:M
Last Name:KASSEES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7277
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19714-7277
Mailing Address - Country:US
Mailing Address - Phone:302-998-6181
Mailing Address - Fax:
Practice Address - Street 1:2601 ANNAND DR
Practice Address - Street 2:SUITE 7
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-3719
Practice Address - Country:US
Practice Address - Phone:302-998-6181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC0000201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000030345Medicaid
DE1000034830Medicaid