Provider Demographics
NPI:1184260457
Name:CASSISTRE, ROBERT JAMES (LPC-INTERN)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:CASSISTRE
Suffix:
Gender:M
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 BABCOCK RD STE 232
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4741
Mailing Address - Country:US
Mailing Address - Phone:210-429-7981
Mailing Address - Fax:
Practice Address - Street 1:1603 BABCOCK RD STE 232
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4741
Practice Address - Country:US
Practice Address - Phone:210-429-7981
Practice Address - Fax:210-579-1516
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78783101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health