Provider Demographics
NPI:1710731039
Name:LESCO, KASSANDRA O (MSW)
Entity Type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:O
Last Name:LESCO
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 1:3611 W 46TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-4535
Mailing Address - Country:US
Mailing Address - Phone:307-262-6822
Mailing Address - Fax:
Practice Address - Street 1:230 N PARK ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2042
Practice Address - Country:US
Practice Address - Phone:307-265-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical