Jeffrey E Cassisi, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

#3120 Issued in NC

Practice address

1200 Murchison Rd
Dept of Psychology, Fayetteville State University
Fayetteville, NC 28301-4252

Phone

(910) 672-1577

Fax

(910) 672-1043

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396899100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 BENTWILLOW DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268686",
            "telephone_number": "919-889-9625",
            "fax_number": "910-672-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MURCHISON RD",
            "address_2": "DEPT OF PSYCHOLOGY, FAYETTEVILLE STATE UNIVERSITY",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014252",
            "telephone_number": "910-672-1577",
            "fax_number": "910-672-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSISI",
        "first_name": "JEFFREY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "#3120",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 3989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Anali Casarrubias Ramirez
• Carl Bruce Casciere, PT
• Lauren Ann Casey, PT, DPT
• Brittany Caskey, PHARMD
• Myrna Cassion, NP
• Stephanie Hopkins Castellat, PHARMD
• Kevin Castillo, DO
• Dennis Manalac Castor, LPT
• Isabella Maria Castro-Barros
• Abighail Cuyugan Castro, DPT

• Clinical Psychologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.