Provider Demographics
NPI:1932639960
Name:PARKER, CASSANDRA PETERS (LSCSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:PETERS
Last Name:PARKER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:RENEE
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1368
Mailing Address - Country:US
Mailing Address - Phone:785-830-1823
Mailing Address - Fax:
Practice Address - Street 1:200 MAINE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1368
Practice Address - Country:US
Practice Address - Phone:785-830-1823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10431104100000X
KS54521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker