Provider Demographics
NPI:1528258092
Name:KEMMERER, CASSANDRA ANNE (LPC,LMFT)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:ANNE
Last Name:KEMMERER
Suffix:
Gender:F
Credentials:LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-2522
Mailing Address - Country:US
Mailing Address - Phone:318-673-1010
Mailing Address - Fax:318-673-1424
Practice Address - Street 1:2620 CENTENARY BLVD
Practice Address - Street 2:BLDG. 1 STE. 118
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-3356
Practice Address - Country:US
Practice Address - Phone:318-673-1010
Practice Address - Fax:318-673-1424
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2582101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional