Provider Demographics
NPI:1023638921
Name:KASSAR, ULRICA LATASHA (MA, LPC)
Entity type:Individual
Prefix:
First Name:ULRICA
Middle Name:LATASHA
Last Name:KASSAR
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5911 KESLER DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1066
Mailing Address - Country:US
Mailing Address - Phone:682-235-6131
Mailing Address - Fax:
Practice Address - Street 1:5911 KESLER DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1066
Practice Address - Country:US
Practice Address - Phone:682-235-6131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72600101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor