Provider Demographics
NPI:1588719975
Name:CASSEL, LYNETTE INGRAM (MS, ATR, LMHC)
Entity type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:INGRAM
Last Name:CASSEL
Suffix:
Gender:F
Credentials:MS, ATR, LMHC
Other - Prefix:
Other - First Name:LYNETTE
Other - Middle Name:MICHELE
Other - Last Name:INGRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:259 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8406
Mailing Address - Country:US
Mailing Address - Phone:617-855-5749
Mailing Address - Fax:
Practice Address - Street 1:259 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8406
Practice Address - Country:US
Practice Address - Phone:617-855-5749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health