Provider Demographics
NPI:1114682176
Name:SWEIDAN, CASSANDRA L (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:L
Last Name:SWEIDAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-1518
Mailing Address - Country:US
Mailing Address - Phone:734-612-4414
Mailing Address - Fax:
Practice Address - Street 1:328 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-1518
Practice Address - Country:US
Practice Address - Phone:734-612-4414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010976541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical