Provider Demographics
NPI:1285717769
Name:KASS, ANDREW J (MA, LPC, DAPA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:KASS
Suffix:
Gender:M
Credentials:MA, LPC, DAPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BUTTONWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-5613
Mailing Address - Country:US
Mailing Address - Phone:203-217-2781
Mailing Address - Fax:203-626-5223
Practice Address - Street 1:731C BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4704
Practice Address - Country:US
Practice Address - Phone:203-929-2400
Practice Address - Fax:203-929-5202
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000378101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional