Provider Demographics
NPI:1396109724
Name:WHITFIELD, CASSANDRA (MA, LCSW)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 W ESTES AVE
Mailing Address - Street 2:2I
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-5493
Mailing Address - Country:US
Mailing Address - Phone:253-222-4901
Mailing Address - Fax:
Practice Address - Street 1:1369 W ESTES AVE
Practice Address - Street 2:2I
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-5493
Practice Address - Country:US
Practice Address - Phone:253-222-4901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0183991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical