Provider Demographics
NPI:1811624760
Name:GAMBER, CASSANDRA (LMSW)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:GAMBER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:LONE JACK
Mailing Address - State:MO
Mailing Address - Zip Code:64070-0114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:441 NW W HWY
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64061-9117
Practice Address - Country:US
Practice Address - Phone:816-308-0246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022025652104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker