Individual ProviderCassandra ContonCounselorBehavioral Health & Social Service ProvidersPractice Address1803 Over Lake Dr SE, Suite C, Conyers, GA 30013-1789(770) 679-4043PECOS EnrollmentBased on the most recent information from CMS, provider Cassandra Conton does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1932344645Provider TypeIndividualFull NameConton, CassandraCredentialLPCGenderFemaleSole ProprietorNoEnumeration Date12/9/2008Last Updated6/22/2012Contact InformationPractice LocationPractice Address1803 Over Lake Dr SE, Suite C, Conyers, GA 30013-1789Phone(770) 679-4043Fax(770) 679-4915Mailing LocationMailing Address1803 Over Lake Dr SE, Suite C, Conyers, GA 30013-1789Phone(770) 679-4043Fax(770) 679-4915Provider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseLPC004669GeorgiaProvider IdentifiersIDDescriptionIssuerID202I688017DescriptionOtherIssuerMEDICARE- PTANGeorgiaID159828861ADescriptionMedicaidIssuerUnlistedGeorgiaID202G708017DescriptionOtherIssuerMEDICARE-GROUP PTANGeorgia