Provider Demographics
NPI:1457068751
Name:QUICK, CASSANDRA CELESTE (LCSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:CELESTE
Last Name:QUICK
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 1:153 N 100 W
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6111
Mailing Address - Country:US
Mailing Address - Phone:801-971-9930
Mailing Address - Fax:
Practice Address - Street 1:780 S 2000 W STE E302
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-9611
Practice Address - Country:US
Practice Address - Phone:801-628-6397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10868785-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical