Provider Demographics
NPI:1508190653
Name:SPOHN, CASSIE NICOLE
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:NICOLE
Last Name:SPOHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 N DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1008
Mailing Address - Country:US
Mailing Address - Phone:303-377-2820
Mailing Address - Fax:303-860-4500
Practice Address - Street 1:1728 N DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1008
Practice Address - Country:US
Practice Address - Phone:303-377-2820
Practice Address - Fax:303-860-4500
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CO1-16-24728103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator