Provider Demographics
NPI:1679253801
Name:CASIAS, CINDY GRISEL (LPC)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:GRISEL
Last Name:CASIAS
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 1:3701 LILLY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-3394
Mailing Address - Country:US
Mailing Address - Phone:678-779-6528
Mailing Address - Fax:
Practice Address - Street 1:760 LONGLEAF BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-8458
Practice Address - Country:US
Practice Address - Phone:678-376-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional