Provider Demographics
NPI:1750627063
Name:ADDISON, CHASSIDY KASHUNDA (MA)
Entity type:Individual
Prefix:MISS
First Name:CHASSIDY
Middle Name:KASHUNDA
Last Name:ADDISON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 C M FAGAN DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6043
Mailing Address - Country:US
Mailing Address - Phone:985-542-2223
Mailing Address - Fax:985-542-2206
Practice Address - Street 1:902 C M FAGAN DR
Practice Address - Street 2:SUITE H
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-542-2223
Practice Address - Fax:985-542-2206
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health