Provider Demographics
NPI:1174244016
Name:TRASK, CASSANDRA
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:TRASK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GIFFORD LN
Mailing Address - Street 2:
Mailing Address - City:YANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06389-1002
Mailing Address - Country:US
Mailing Address - Phone:860-334-0639
Mailing Address - Fax:
Practice Address - Street 1:335 CHANDLER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-3441
Practice Address - Country:US
Practice Address - Phone:508-421-4454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health