Provider Demographics
NPI:1073643755
Name:STAJICH-TRIMMER, CASSANDRA ANN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:ANN
Last Name:STAJICH-TRIMMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:STAJICH-TRIMMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW, CTC
Mailing Address - Street 1:2006 HOGBACK RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9750
Mailing Address - Country:US
Mailing Address - Phone:734-786-2300
Mailing Address - Fax:734-786-4915
Practice Address - Street 1:2006 HOGBACK RD STE 1
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9750
Practice Address - Country:US
Practice Address - Phone:734-786-2300
Practice Address - Fax:734-786-4915
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801077324104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N61390016Medicare ID - Type UnspecifiedUNDER PIONEER COUNSELING