Healthcare Provider Details

I. General information

NPI: 1255763538
Provider Name (Legal Business Name): CASSANDRA DOWNEY LPC, SAC-IT, CS-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 W LINCOLN AVE
WEST ALLIS WI
53227-2136
US

IV. Provider business mailing address

PO BOX 241413
MILWAUKEE WI
53224-9032
US

V. Phone/Fax

Practice location:
  • Phone: 414-372-3903
  • Fax:
Mailing address:
  • Phone: 414-433-7582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1841-226
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5987-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: