Provider Demographics
NPI:1518362102
Name:MCDONALD, CASSANDRA (CDCA)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4157 RUPLE RD APT 4
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2835
Mailing Address - Country:US
Mailing Address - Phone:216-925-9854
Mailing Address - Fax:
Practice Address - Street 1:4157 RUPLE RD APT 4
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2835
Practice Address - Country:US
Practice Address - Phone:216-925-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-26
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH140999101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)