Provider Demographics
NPI:1780290163
Name:MACMILLER, CASSIE A (MSW, CAPSW)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:A
Last Name:MACMILLER
Suffix:
Gender:
Credentials:MSW, CAPSW
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:A
Other - Last Name:HOHLSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-2183
Mailing Address - Country:US
Mailing Address - Phone:608-355-4200
Mailing Address - Fax:
Practice Address - Street 1:505 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-2183
Practice Address - Country:US
Practice Address - Phone:608-355-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI132860-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker