Provider Demographics
NPI:1861015208
Name:CASSIE SEGERSON COUNSELING, PLLC
Entity type:Organization
Organization Name:CASSIE SEGERSON COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-772-6390
Mailing Address - Street 1:4330 BULL CREEK RD APT 2408
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5954
Mailing Address - Country:US
Mailing Address - Phone:254-640-0669
Mailing Address - Fax:
Practice Address - Street 1:1211 ALEXANDER AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2421
Practice Address - Country:US
Practice Address - Phone:720-772-6390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)