Provider Demographics
NPI:1053538918
Name:KASE, LARINA (PSYD)
Entity type:Individual
Prefix:DR
First Name:LARINA
Middle Name:
Last Name:KASE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 KRAMS AVE
Mailing Address - Street 2:C-1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1258
Mailing Address - Country:US
Mailing Address - Phone:215-370-1806
Mailing Address - Fax:215-508-0307
Practice Address - Street 1:3138 BUTLER PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1946
Practice Address - Country:US
Practice Address - Phone:484-530-0778
Practice Address - Fax:484-530-0998
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSO15683103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral