Provider Demographics
NPI:1376322859
Name:RICHARDS, CASSANDRA ANNE (LLMSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ANNE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 N SAGINAW RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2301
Mailing Address - Country:US
Mailing Address - Phone:989-510-7626
Mailing Address - Fax:
Practice Address - Street 1:3600 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2301
Practice Address - Country:US
Practice Address - Phone:989-545-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851117390104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker