Provider Demographics
NPI:1750870432
Name:WEIK, CASSANDRA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:
Last Name:WEIK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:GANIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:484 S PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-4010
Mailing Address - Country:US
Mailing Address - Phone:860-689-4275
Mailing Address - Fax:
Practice Address - Street 1:157 LITCHFIELD STREET
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790
Practice Address - Country:US
Practice Address - Phone:860-489-1328
Practice Address - Fax:860-489-4761
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4310104100000X
104100000X
CT111771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker