Provider Demographics
NPI:1518560408
Name:CASSONDRA FELDMAN, PSY.D., P.A.
Entity Type:Organization
Organization Name:CASSONDRA FELDMAN, PSY.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSONDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-853-9857
Mailing Address - Street 1:1019 KANE CONCOURSE STE 203
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2138
Mailing Address - Country:US
Mailing Address - Phone:305-853-9857
Mailing Address - Fax:305-257-9400
Practice Address - Street 1:1019 KANE CONCOURSE STE 203
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2138
Practice Address - Country:US
Practice Address - Phone:305-853-9857
Practice Address - Fax:305-257-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty