Provider Demographics
NPI:1912404526
Name:CLARKE-WILLIAMS, CASSANDRA (PHD, LGPC)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:
Last Name:CLARKE-WILLIAMS
Suffix:
Gender:F
Credentials:PHD, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10090 MILL RUN CIR APT 423C
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4266
Mailing Address - Country:US
Mailing Address - Phone:443-621-7676
Mailing Address - Fax:
Practice Address - Street 1:5570 STERRETT PL STE 305
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2654
Practice Address - Country:US
Practice Address - Phone:443-485-5473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP5575101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health