Healthcare Provider Details

I. General information

NPI: 1881038198
Provider Name (Legal Business Name): CASSANDRA T. BUTLER CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASSANDRA T. GRANT LCSW

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 HIGHWAY, 468 WEST
WHITFIELD MS
39193-0157
US

IV. Provider business mailing address

P.O. BOX 1 - FISCAL SERVICES 3550 HIGHWAY, 468 WEST
WHITFIELD MS
39193-0157
US

V. Phone/Fax

Practice location:
  • Phone: 601-351-8000
  • Fax:
Mailing address:
  • Phone: 601-351-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-7298
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: