Provider Demographics
NPI:1841921137
Name:CORE-HOLT, CASSANDRA ANITA (LMFT-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ANITA
Last Name:CORE-HOLT
Suffix:
Gender:F
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 KENNEY DR
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-7685
Mailing Address - Country:US
Mailing Address - Phone:254-368-7707
Mailing Address - Fax:
Practice Address - Street 1:3011 N MAIN ST UNIT B
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1139
Practice Address - Country:US
Practice Address - Phone:254-307-2495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-18
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204407106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty