Provider Demographics
NPI:1215822424
Name:WILLIAMS, CASSEN BLACK (MED CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CASSEN
Middle Name:BLACK
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13626 S CLOUDYWING WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-6996
Mailing Address - Country:US
Mailing Address - Phone:385-259-5464
Mailing Address - Fax:
Practice Address - Street 1:310 E 4500 S STE 210
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3993
Practice Address - Country:US
Practice Address - Phone:435-222-4883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty