Provider Demographics
NPI:1194347955
Name:ALYSSA CASCIOTTA PSYD LLC
Entity type:Organization
Organization Name:ALYSSA CASCIOTTA PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASCIOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, HSPP
Authorized Official - Phone:812-437-0095
Mailing Address - Street 1:4929 RIVERWIND POINTE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-6753
Mailing Address - Country:US
Mailing Address - Phone:812-437-0095
Mailing Address - Fax:812-437-0096
Practice Address - Street 1:4929 RIVER WIND POINTE DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-6753
Practice Address - Country:US
Practice Address - Phone:812-437-0095
Practice Address - Fax:812-437-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty