Provider Demographics
NPI:1982189056
Name:RICE, CASSANDRA M (LCSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:M
Last Name:RICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MONTAUK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4906
Mailing Address - Country:US
Mailing Address - Phone:860-271-4783
Mailing Address - Fax:860-333-1390
Practice Address - Street 1:21 MONTAUK AVE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4906
Practice Address - Country:US
Practice Address - Phone:860-442-0564
Practice Address - Fax:860-333-1390
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT103381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical