Provider Demographics
NPI:1174516470
Name:CASSEL, STEVEN B (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:CASSEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 NW 33RD AVE
Mailing Address - Street 2:STE 221
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-6376
Mailing Address - Country:US
Mailing Address - Phone:954-234-0622
Mailing Address - Fax:954-345-5504
Practice Address - Street 1:5310 NW 33RD AVE
Practice Address - Street 2:STE 221
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-6376
Practice Address - Country:US
Practice Address - Phone:954-234-0622
Practice Address - Fax:954-345-5504
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3898103TP0814X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73340Medicare UPIN
73340Medicare ID - Type Unspecified