Provider Demographics
NPI:1962504308
Name:CASSADY, SYLVIA SMOLENSKI
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:SMOLENSKI
Last Name:CASSADY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 BLACKWATER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62712-8313
Mailing Address - Country:US
Mailing Address - Phone:217-553-4662
Mailing Address - Fax:
Practice Address - Street 1:386 S KOKE MILL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-8058
Practice Address - Country:US
Practice Address - Phone:217-553-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker