Provider Demographics
NPI:1649945247
Name:CASSELL COUNSELING LLC
Entity type:Organization
Organization Name:CASSELL COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:B
Authorized Official - Last Name:CASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-378-4324
Mailing Address - Street 1:1619 ASHURST RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2713
Mailing Address - Country:US
Mailing Address - Phone:484-424-7355
Mailing Address - Fax:484-930-0873
Practice Address - Street 1:1619 ASHURST RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2713
Practice Address - Country:US
Practice Address - Phone:484-424-7355
Practice Address - Fax:484-930-0873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10245OtherNC LCMHC