Provider Demographics
NPI:1700526886
Name:STANISLOO, CASSANDRA (MSW, LICSWA)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:STANISLOO
Suffix:
Gender:F
Credentials:MSW, LICSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3543
Mailing Address - Country:US
Mailing Address - Phone:509-469-3727
Mailing Address - Fax:
Practice Address - Street 1:504 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3543
Practice Address - Country:US
Practice Address - Phone:509-469-3727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASWIC.SC.612742251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical