Healthcare Provider Details

I. General information

NPI: 1720849854
Provider Name (Legal Business Name): CASSANDRA HOWARD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 05/21/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OPC 80 BOX 5217
APO AP
96368-5217
US

IV. Provider business mailing address

3352 EISENHOWER DR
HOLIDAY FL
34691-3317
US

V. Phone/Fax

Practice location:
  • Phone: 315-634-0433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22433
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: