Provider Demographics
NPI:1477096543
Name:CASCIO, KSUSHA (LMSW)
Entity Type:Individual
Prefix:
First Name:KSUSHA
Middle Name:
Last Name:CASCIO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KSUSHA
Other - Middle Name:
Other - Last Name:DEVAULT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:38 TARPON RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778
Mailing Address - Country:US
Mailing Address - Phone:631-461-7331
Mailing Address - Fax:
Practice Address - Street 1:38 TARPON RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778
Practice Address - Country:US
Practice Address - Phone:631-461-7331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9459916104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker