Provider Demographics
NPI:1255609608
Name:CASCIO, KRISTEN ELIZABETH (LICSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:CASCIO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:231 INDEPENDENCE AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7751
Mailing Address - Country:US
Mailing Address - Phone:781-752-6351
Mailing Address - Fax:508-697-1829
Practice Address - Street 1:1 LAKESHORE CENTER
Practice Address - Street 2:SENIOR WHOLE HEALTH- 3RD FLOOR
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02141
Practice Address - Country:US
Practice Address - Phone:781-994-7464
Practice Address - Fax:508-697-1829
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA120249OtherSTATE OF MASSACHUSETTS LICENSURE