Provider Demographics
NPI:1649527078
Name:CASHMAN, MARY L (LPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:CASHMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MAPLE AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-5448
Mailing Address - Country:US
Mailing Address - Phone:860-794-4285
Mailing Address - Fax:
Practice Address - Street 1:1171 MAIN ST
Practice Address - Street 2:UNIT 5
Practice Address - City:COVENTRY
Practice Address - State:CT
Practice Address - Zip Code:06238-3116
Practice Address - Country:US
Practice Address - Phone:860-794-4285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-03
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001415101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional