Provider Demographics
NPI:1184069312
Name:D'ADDEO, CASSANDRA LUCIA (MS, LMFT)
Entity type:Individual
Prefix:MISS
First Name:CASSANDRA
Middle Name:LUCIA
Last Name:D'ADDEO
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 LENA RD UNIT 106
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-9499
Mailing Address - Country:US
Mailing Address - Phone:954-632-4146
Mailing Address - Fax:
Practice Address - Street 1:5454 LENA RD UNIT 106
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211
Practice Address - Country:US
Practice Address - Phone:954-632-4146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.000895106H00000X
FL3208106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist