Provider Demographics
NPI:1760746085
Name:POPEK, CASSAUNDRA E (LMFT, ERPSCC, PMH-C)
Entity Type:Individual
Prefix:
First Name:CASSAUNDRA
Middle Name:E
Last Name:POPEK
Suffix:
Gender:F
Credentials:LMFT, ERPSCC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-4458
Mailing Address - Country:US
Mailing Address - Phone:860-331-9548
Mailing Address - Fax:860-969-2939
Practice Address - Street 1:24 BATTLE ST STE 2A
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:CT
Practice Address - Zip Code:06071-1629
Practice Address - Country:US
Practice Address - Phone:860-331-9548
Practice Address - Fax:860-969-2939
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMFT10000065106H00000X
CT001730106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist