Provider Demographics
NPI:1508510868
Name:DENHAM, CASSANDRA LEIGH (LMHC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LEIGH
Last Name:DENHAM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-2767
Mailing Address - Country:US
Mailing Address - Phone:352-844-2004
Mailing Address - Fax:
Practice Address - Street 1:412 W NOBLE AVE STE 4
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-2034
Practice Address - Country:US
Practice Address - Phone:352-844-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19121101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health