Provider Demographics
NPI:1518624469
Name:CASCAVITA, MARIA P (CSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:P
Last Name:CASCAVITA
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 W 1600 N
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-3324
Mailing Address - Country:US
Mailing Address - Phone:516-368-5922
Mailing Address - Fax:
Practice Address - Street 1:2480 S MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:SOUTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84115-5002
Practice Address - Country:US
Practice Address - Phone:801-349-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-25
Last Update Date:2021-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11164610-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty