Provider Demographics
NPI:1558090076
Name:THOMAS, CASSANDRA JEAN (LPC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JEAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W 47TH PL
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-1713
Mailing Address - Country:US
Mailing Address - Phone:719-246-2122
Mailing Address - Fax:
Practice Address - Street 1:2120 MILESTONE DR STE 103
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5761
Practice Address - Country:US
Practice Address - Phone:970-660-8048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0017599101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional