Healthcare Provider Details

I. General information

NPI: 1528907565
Provider Name (Legal Business Name): CASSANDRA LAVALETTE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 S MAIN ST
FALL RIVER MA
02724-2821
US

IV. Provider business mailing address

649 ALDEN ST APT 104
FALL RIVER MA
02723-1827
US

V. Phone/Fax

Practice location:
  • Phone: 774-271-5239
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2309514
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: