Provider Demographics
NPI:1598954257
Name:CASSITY, ALICIA KATHERINE (MA, LPC-S)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:KATHERINE
Last Name:CASSITY
Suffix:
Gender:F
Credentials:MA, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 W. NORTHWEST HWY.
Mailing Address - Street 2:1105
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-3425
Mailing Address - Country:US
Mailing Address - Phone:214-987-1438
Mailing Address - Fax:
Practice Address - Street 1:9304 FOREST LN
Practice Address - Street 2:100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:214-340-0208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health