Healthcare Provider Details

I. General information

NPI: 1053500918
Provider Name (Legal Business Name): SARA ANNE CASSANO M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 03/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 N MOUNTAIN RD
NEW BRITAIN CT
06053-3468
US

IV. Provider business mailing address

75 N MOUNTAIN RD
NEW BRITAIN CT
06053-3468
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-6385
  • Fax:
Mailing address:
  • Phone: 860-224-6385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: