Provider Demographics
NPI:1194113035
Name:PADILLA, CASSIE (LMFT, LPCC)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:
Last Name:PADILLA
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36254
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-0254
Mailing Address - Country:US
Mailing Address - Phone:805-601-7592
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 36254
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80236-0254
Practice Address - Country:US
Practice Address - Phone:805-601-7592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6591101YP2500X
CO18451101YP2500X
CO2194106H00000X
CA109292106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional