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General NPI Number Information
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NPI Number | 1508510868
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Entity Type | Individual
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Provider Name | CASSANDRA LEIGH DENHAM LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 412 W NOBLE AVE STE 4
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City | WILLISTON
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State | FL
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Zip | 32696-2034
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Country | US
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Telephone | 352-844-2004
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Fax |
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Provider Business Mailing Address
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Address Line | 420 SE 4TH AVE
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City | WILLISTON
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State | FL
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Zip | 32696-2767
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Country | US
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Telephone | 352-844-2004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH19121
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License Number State | FL
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