Healthcare Provider Details

I. General information

NPI: 1396593950
Provider Name (Legal Business Name): CASSIE CIPRIANI MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7330 W COLLEGE DR
PALOS HEIGHTS IL
60463-1157
US

IV. Provider business mailing address

208 E RAVINE AVE
WILLOW SPRINGS IL
60480-1454
US

V. Phone/Fax

Practice location:
  • Phone: 773-796-4048
  • Fax:
Mailing address:
  • Phone: 815-922-2082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149020760
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: