Provider Demographics
NPI:1336208370
Name:CASSIUS, ERIC DANIEL (LPC, MHSP, CHT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:DANIEL
Last Name:CASSIUS
Suffix:
Gender:M
Credentials:LPC, MHSP, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 MOUNT MORIAH RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-5704
Mailing Address - Country:US
Mailing Address - Phone:901-685-5491
Mailing Address - Fax:901-685-8292
Practice Address - Street 1:815 MOUNT MORIAH RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-5704
Practice Address - Country:US
Practice Address - Phone:901-685-5491
Practice Address - Fax:901-685-8292
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000793101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
3157550OtherBLUE CROSS BLUE SHIELD