Provider Demographics
NPI:1538832316
Name:CASSITY, CRESCENCIA DENISE (LPC)
Entity type:Individual
Prefix:MRS
First Name:CRESCENCIA
Middle Name:DENISE
Last Name:CASSITY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CRESCENCIA
Other - Middle Name:DENISE
Other - Last Name:HAMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:LAC DU FLAMBEAU
Mailing Address - State:WI
Mailing Address - Zip Code:54538-0189
Mailing Address - Country:US
Mailing Address - Phone:715-588-1511
Mailing Address - Fax:715-588-3903
Practice Address - Street 1:533 PEACE PIPE RD
Practice Address - Street 2:
Practice Address - City:LAC DU FLAMBEAU
Practice Address - State:WI
Practice Address - Zip Code:54538-9123
Practice Address - Country:US
Practice Address - Phone:715-588-1511
Practice Address - Fax:715-588-3903
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10531-125101YP2500X
WI5037-226101YP2500X
WI5037226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional