Healthcare Provider Details

I. General information

NPI: 1679626931
Provider Name (Legal Business Name): CASSANDRA CAUBLE MSW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASSANDRA COLLMAR MSW LCSW

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5533 E BELL RD SUITE 127
SCOTTSDALE AZ
85254-1228
US

IV. Provider business mailing address

5533 E BELL RD SUITE 127
SCOTTSDALE AZ
85254-1228
US

V. Phone/Fax

Practice location:
  • Phone: 602-867-4905
  • Fax: 602-867-4824
Mailing address:
  • Phone: 602-867-4905
  • Fax: 602-867-4824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-2747
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: