Provider Demographics
NPI:1982966453
Name:CHAPPINA, CASSANDRA LYN (MSED, BCBA)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYN
Last Name:CHAPPINA
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:LYN
Other - Last Name:PURICELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED, BCBA
Mailing Address - Street 1:9 MILTON ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2606
Mailing Address - Country:US
Mailing Address - Phone:516-445-6412
Mailing Address - Fax:
Practice Address - Street 1:9 MILTON ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2606
Practice Address - Country:US
Practice Address - Phone:516-445-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
1-18-30830103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist