Provider Demographics
NPI:1235802281
Name:JOLICOEUR, CASSANDRA (LMSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:JOLICOEUR
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 1:151 89TH ST APT D2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5563
Mailing Address - Country:US
Mailing Address - Phone:862-432-3572
Mailing Address - Fax:
Practice Address - Street 1:151 89TH ST APT D2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5563
Practice Address - Country:US
Practice Address - Phone:862-432-3572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092547104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker