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NPI Code Detail

MEDICARE: MARY ELIZABETH CASSEL MFT

MEDICARE: MARY ELIZABETH CASSEL MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC31936CA

General Provider Information

NPI Number : 1578767257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ELIZABETH CASSEL MFT
Provider Business Mailing Address
First Line : 207 TERRACE AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-2643
Country : US
Telephone Number : 415-721-7116
Fax Number : 415-459-0362
Provider Business Practice Location Address
First Line : 5028 GEARY BLVD
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94118-2814
Country : US
Telephone Number : 415-289-2241
Fax Number : 415-459-0362
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2007
Last Update Date : 07/08/2007

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Directions to “ MARY ELIZABETH CASSEL MFT” Practice Location

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