MEDICARE: CASSONDRA OHM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275046583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSONDRA OHM

Provider Business Mailing Address
First Line	:	2940 CHAPEL VALLEY RD STE 2
Second Line	:
City	:	FITCHBURG
State	:	WI
Zip	:	53711-6451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 REGENT ST STE 201
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53715-2649
Country	:	US
Telephone Number	:	608-709-9672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2017
Last Update Date	:	12/09/2025

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Directions to “ CASSONDRA OHM ” Practice Location

Language	Start Address	Practice Location

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