Provider Demographics
NPI:1336873173
Name:FITCH, CASSAUNDRA ANN (LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:CASSAUNDRA
Middle Name:ANN
Last Name:FITCH
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 S CONGRESS AVE APT 1420
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-2037
Mailing Address - Country:US
Mailing Address - Phone:248-214-4690
Mailing Address - Fax:
Practice Address - Street 1:3724 JEFFERSON ST STE 207
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6221
Practice Address - Country:US
Practice Address - Phone:248-214-4690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health