Provider Demographics
NPI:1972862589
Name:KEMP, CASSANDRA KAYE
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:KAYE
Last Name:KEMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11309 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-2802
Mailing Address - Country:US
Mailing Address - Phone:918-949-7801
Mailing Address - Fax:
Practice Address - Street 1:1 W 36TH ST N STE 202
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1700
Practice Address - Country:US
Practice Address - Phone:918-425-4200
Practice Address - Fax:918-425-4201
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)