Provider Demographics
NPI:1659113140
Name:OVERSTREET SILVA, KASSANDRA RENEE (MS, LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:RENEE
Last Name:OVERSTREET SILVA
Suffix:
Gender:F
Credentials:MS, LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 W NORTHWEST HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-8145
Mailing Address - Country:US
Mailing Address - Phone:817-329-5049
Mailing Address - Fax:
Practice Address - Street 1:1701 W NORTHWEST HWY STE 100
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8145
Practice Address - Country:US
Practice Address - Phone:817-329-5049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health