Provider Demographics
NPI:1912620485
Name:CASIMIR, CASSANDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:CASIMIR
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 1:10103 VIA COLOMBA CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-6552
Mailing Address - Country:US
Mailing Address - Phone:239-877-4915
Mailing Address - Fax:
Practice Address - Street 1:9250 CORKSCREW RD SUITE 12
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-3216
Practice Address - Country:US
Practice Address - Phone:239-266-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW186331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000000OtherUNKNOWN