Provider Demographics
NPI:1285059626
Name:MASTRIANNI, CASSANDRA CATHERINE (LPC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:CATHERINE
Last Name:MASTRIANNI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:CATHERINE
Other - Last Name:MASTRIANNI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:38 MICHAEL TERRACE
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716
Mailing Address - Country:US
Mailing Address - Phone:203-560-1893
Mailing Address - Fax:
Practice Address - Street 1:70 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1207
Practice Address - Country:US
Practice Address - Phone:203-560-1893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CT3076101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor