Healthcare Provider Details

I. General information

NPI: 1962172460
Provider Name (Legal Business Name): CASSANDRA CACACE LMFT, PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HARVEY S PEELER JR COLLEGE OF VETERINARY MEDICINE
CLEMSON SC
29634-0001
US

IV. Provider business mailing address

BOX 344054
CLEMSON SC
29634-0001
US

V. Phone/Fax

Practice location:
  • Phone: 864-656-2451
  • Fax:
Mailing address:
  • Phone: 864-656-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number7915
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: