Provider Demographics
NPI:1134848898
Name:MOORE, CASSIE LEE (LAMFT)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:LEE
Last Name:MOORE
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:LEE
Other - Last Name:KNECHEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAMF
Mailing Address - Street 1:25 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-1815
Mailing Address - Country:US
Mailing Address - Phone:917-364-7352
Mailing Address - Fax:
Practice Address - Street 1:25 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-1815
Practice Address - Country:US
Practice Address - Phone:917-364-7352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FA00028000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health