Provider Demographics
NPI:1629356928
Name:KASAPIS, CHRYSOULA (PHD)
Entity Type:Individual
Prefix:
First Name:CHRYSOULA
Middle Name:
Last Name:KASAPIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MERRICK RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2501
Mailing Address - Country:US
Mailing Address - Phone:800-725-6280
Mailing Address - Fax:800-725-6380
Practice Address - Street 1:303 MERRICK RD
Practice Address - Street 2:SUITE 204
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2501
Practice Address - Country:US
Practice Address - Phone:800-725-6280
Practice Address - Fax:800-725-6380
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013111103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical