CASSANDRA CHARLES-TABACCO NPI 1811417082

NPI Information

NPI: 1811417082
Provider Name: CASSANDRA CHARLES-TABACCO
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
180 FAIRFIELD AVE
BRIDGEPORT, CT
ZIP 06604
Phone: (203) 394-6529
Get Directions

Cassandra Charles-tabacco is a professional counselor in Bridgeport, CT. Cassandra Charles-tabacco NPI is 1811417082. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

180 FAIRFIELD AVE
BRIDGEPORT, CT
ZIP 06604-252
Phone: (203) 394-6529
Fax: (203) 610-6131

The enumeration date for this NPI number is 6/20/2017 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional		CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	06-0669106	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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