Provider Demographics
NPI:1295243657
Name:CASCIATO, CARON MARIE (PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:CARON
Middle Name:MARIE
Last Name:CASCIATO
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 JOH AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:HALETHORPE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1135
Mailing Address - Country:US
Mailing Address - Phone:443-800-0470
Mailing Address - Fax:888-760-4333
Practice Address - Street 1:1502 JOH AVE STE 180
Practice Address - Street 2:
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-1135
Practice Address - Country:US
Practice Address - Phone:443-800-0470
Practice Address - Fax:888-760-4333
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05251103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist