Provider Demographics
NPI:1225285836
Name:WIGINGTON, CASSI CORINN (PLMHP, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CASSI
Middle Name:CORINN
Last Name:WIGINGTON
Suffix:
Gender:F
Credentials:PLMHP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13057 W CENTER RD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3748
Mailing Address - Country:US
Mailing Address - Phone:402-333-7502
Mailing Address - Fax:402-333-7504
Practice Address - Street 1:13057 W CENTER RD
Practice Address - Street 2:SUITE 25
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3748
Practice Address - Country:US
Practice Address - Phone:402-333-7502
Practice Address - Fax:402-333-7504
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health