Individual
CASSANDRA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW, LADC
Contact information
Practice address
12110 PORT GRACE BLVD STE 101, LA VISTA, NE 68128-3190
(402) 645-0038
Mailing address
12110 PORT GRACE BLVD STE 101, LA VISTA, NE 68128-3190
(402) 645-0038
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1596
NE
1041C0700X
Clinical Social Worker
Primary
2915
NE
Other
Enumeration date
06/28/2022
Last updated
08/15/2024
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