Provider Demographics
NPI:1760950679
Name:MANALASTAS, MARIA CASSANDRA RIVILLA (LMHCA)
Entity Type:Individual
Prefix:
First Name:MARIA CASSANDRA
Middle Name:RIVILLA
Last Name:MANALASTAS
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 S GUNNISON ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-2327
Mailing Address - Country:US
Mailing Address - Phone:206-953-8734
Mailing Address - Fax:
Practice Address - Street 1:3317 S GUNNISON ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-2327
Practice Address - Country:US
Practice Address - Phone:253-525-2120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program