Provider Demographics
NPI:1528405222
Name:SAASA, SHERINA KACANA (MSW)
Entity Type:Individual
Prefix:
First Name:SHERINA
Middle Name:KACANA
Last Name:SAASA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 N 900 E
Mailing Address - Street 2:UTAH PROVO AGENCY
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3536
Mailing Address - Country:US
Mailing Address - Phone:801-422-7620
Mailing Address - Fax:801-422-0165
Practice Address - Street 1:1190 N 900 E
Practice Address - Street 2:UTAH PROVO AGENCY
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3536
Practice Address - Country:US
Practice Address - Phone:801-422-7620
Practice Address - Fax:801-422-0165
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW - 329291041C0700X
UT8572474-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical