Provider Demographics
NPI:1811653553
Name:FORD, CASSANDRA (MS)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-1099
Mailing Address - Country:US
Mailing Address - Phone:781-558-9602
Mailing Address - Fax:
Practice Address - Street 1:184 BROADWAY
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-1099
Practice Address - Country:US
Practice Address - Phone:781-558-9602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor