Provider Demographics
NPI:1174636682
Name:SHERIFF, CASSANDRA CLEOTHA (MS, SST)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:CLEOTHA
Last Name:SHERIFF
Suffix:
Gender:F
Credentials:MS, SST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23061 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2019
Mailing Address - Country:US
Mailing Address - Phone:313-575-5531
Mailing Address - Fax:
Practice Address - Street 1:19170 EUREKA RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2985
Practice Address - Country:US
Practice Address - Phone:734-324-8326
Practice Address - Fax:734-324-8327
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6803085306101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health