Provider Demographics
NPI:1790259109
Name:CENTER FOR AUTISM, ASSERTIVENESS & SOCIAL SKILLS (CAASS) LTD
Entity Type:Organization
Organization Name:CENTER FOR AUTISM, ASSERTIVENESS & SOCIAL SKILLS (CAASS) LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC
Authorized Official - Phone:614-209-0428
Mailing Address - Street 1:2611 DEMING AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-2417
Mailing Address - Country:US
Mailing Address - Phone:614-209-0428
Mailing Address - Fax:614-437-1554
Practice Address - Street 1:4041 N HIGH ST STE 300N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3200
Practice Address - Country:US
Practice Address - Phone:614-352-2946
Practice Address - Fax:614-437-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1487105144Medicaid