Provider Demographics
NPI:1134310741
Name:CASSELLA, SABRINA L (OTR/L)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:L
Last Name:CASSELLA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 BIRNIE AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1107
Practice Address - Country:US
Practice Address - Phone:413-781-1054
Practice Address - Fax:413-439-0026
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XH1200X
MA9295225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043527497OtherCONNECTICARE
MA043597497OtherNORTH REGION
MAAA49027OtherHVP
MA103355100OtherDOL
MAOT0328OtherBLUE CROSS
MA035265OtherBMC
MA690675OtherTUFTS
MA64-04290OtherUNITED HEALTHCARE
MA043527497OtherCIGNA
MA043527497OtherGREATWEST
MA043527497OtherGIC
MA972730OtherNETWORK HEALTH
MAPT0191Medicaid
MA043527497OtherCONNECTICARE
MA64-04290OtherUNITED HEALTHCARE
MA972730OtherNETWORK HEALTH