Provider Demographics
NPI:1558899815
Name:SEDLACEK, CASSIE MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:MARIE
Last Name:SEDLACEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:WELSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1210 FOURIER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1969
Mailing Address - Country:US
Mailing Address - Phone:608-662-9327
Mailing Address - Fax:608-662-9041
Practice Address - Street 1:2125 HEIGHTS DR STE 2F
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6146
Practice Address - Country:US
Practice Address - Phone:715-832-2233
Practice Address - Fax:715-833-1666
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8727-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI8727-123OtherDEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES