person
Mr. Jon Ed Kassaw, MALPCC
Mental Health Counselor in Estancia, New Mexico
NPI 1225181035

Jon Ed Kassaw is a Mental Health Counselor based in Estancia, NM and is specialized in Mental Health. Jon Ed Kassaw practices in Estancia, NM and has the professional credentials of MALPCC. The NPI Number for Jon Ed Kassaw is 1225181035 and holds a License No. CCMH0182191 (New Mexico).

The current practice location address for Jon Ed Kassaw is 903C 5Th Street, Estancia, NM and can be reached out via phone at 505-384-2777 and via fax at 505-384-2204.

Location: 903C 5Th Street, Estancia, NM, 87016-0807
person
Provider Profile Details
NPI Number
1225181035
Provider Name
Jon Ed Kassaw
Credential
MALPCC
Provider Entity Type
Individual
Gender
Male
Address
903C 5Th Street, Estancia, NM, 87016-0807
Phone Number
505-384-2777
Fax Number
505-384-2204
Provider Enumeration Date
01/18/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CCMH0182191 01 NM THERAP BOARD
institution
Provider Business Practice Location Address Details
Address
903C 5Th Street
City
State
Zip
87016-0807
Phone Number
505-384-2777
Fax Number
505-384-2204
person
Provider Business Mailing Address Details
Address
903C 5Th Street
City
State
Zip
87016-0807
Phone Number
505-384-2777
Fax Number
505-384-2204
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
CCMH0182191 (New Mexico)
Definition
Definition to come...
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