Provider Demographics
NPI:1730778853
Name:MUSUMECI, CASANDRA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:CASANDRA
Middle Name:
Last Name:MUSUMECI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 821
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-0821
Mailing Address - Country:US
Mailing Address - Phone:585-206-8060
Mailing Address - Fax:
Practice Address - Street 1:535 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-1017
Practice Address - Country:US
Practice Address - Phone:585-406-4267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health