Provider Demographics
NPI:1033098678
Name:STUCKMAN, CASSIDI K (LPCC)
Entity type:Individual
Prefix:
First Name:CASSIDI
Middle Name:K
Last Name:STUCKMAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 20TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-8011
Mailing Address - Country:US
Mailing Address - Phone:785-770-2879
Mailing Address - Fax:
Practice Address - Street 1:2975 VALMONT RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1361
Practice Address - Country:US
Practice Address - Phone:785-770-2879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0022111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health