MEDICARE: KASSANDRA RENDON LPC

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
1	101YP2500X	Professional Counselor	85214	TX

General Provider Information

NPI Number	:	1922708288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASSANDRA RENDON LPC

Provider Business Mailing Address
First Line	:	5454 LA SIERRA DR STE 201
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2344
Country	:	US
Telephone Number	:	210-920-5315
Fax Number	:

Provider Business Practice Location Address
First Line	:	5454 LA SIERRA DR STE 201
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2344
Country	:	US
Telephone Number	:	210-920-5315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	03/17/2026

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Directions to “ KASSANDRA RENDON LPC” Practice Location

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