Provider Demographics
NPI:1497335723
Name:ACRES, CASSIE M
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:M
Last Name:ACRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:M
Other - Last Name:WOHLGEMUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1205 E INTL AIRPORT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1409
Mailing Address - Country:US
Mailing Address - Phone:907-570-6382
Mailing Address - Fax:888-972-3679
Practice Address - Street 1:1205 E INTL AIRPORT RD STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1409
Practice Address - Country:US
Practice Address - Phone:907-570-6382
Practice Address - Fax:888-972-3679
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health