Provider Demographics
NPI:1528204427
Name:FRASCATORE, CASSANDRA A (LPC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:A
Last Name:FRASCATORE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 NEW ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-2324
Mailing Address - Country:US
Mailing Address - Phone:203-895-8585
Mailing Address - Fax:
Practice Address - Street 1:90 SODOM LN
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-2646
Practice Address - Country:US
Practice Address - Phone:203-895-7180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTSCPG- 5574OtherSPECIALTY CERTIFICATE OF COMPETENCY IN PROBLEM GAMBLING
CT08-030OtherREGISTERED ART THERAPIST- ATR