Provider Demographics
NPI:1467651737
Name:KAPSALIS, CASSANDRA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:
Last Name:KAPSALIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CASSY
Other - Middle Name:
Other - Last Name:KAPSALIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:445 BELLEVUE AVE
Mailing Address - Street 2:STE.104
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4923
Mailing Address - Country:US
Mailing Address - Phone:510-525-9394
Mailing Address - Fax:510-452-4046
Practice Address - Street 1:4128 LAKESHORE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-1138
Practice Address - Country:US
Practice Address - Phone:510-452-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT33234101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor