Healthcare Provider Details

I. General information

NPI: 1053903872
Provider Name (Legal Business Name): CASSANDRA ELISABETH BARRON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 APPEAL LN
LUSBY MD
20657-2935
US

IV. Provider business mailing address

9011 MICHAEL WAY
OWINGS MD
20736-9554
US

V. Phone/Fax

Practice location:
  • Phone: 410-394-0681
  • Fax:
Mailing address:
  • Phone: 918-399-8737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB650820
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: