Provider Demographics
NPI:1982937348
Name:COLEMAN-HEPPLER, CASSANDRA (LICSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:COLEMAN-HEPPLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12128 N DIVISION ST # 441
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1905
Mailing Address - Country:US
Mailing Address - Phone:509-990-6560
Mailing Address - Fax:
Practice Address - Street 1:202 E ANTON AVE
Practice Address - Street 2:STE 206
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-3727
Practice Address - Country:US
Practice Address - Phone:208-667-6095
Practice Address - Fax:208-667-6173
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-25735101YM0800X
IDLCSW311441041C0700X
WALW602313361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health