Provider Demographics
NPI:1104550011
Name:LASKOWSKI, CASSANDRA R (MA, LCPC, CADC)
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:R
Last Name:LASKOWSKI
Suffix:
Gender:F
Credentials:MA, LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 521
Mailing Address - Street 2:
Mailing Address - City:MAROA
Mailing Address - State:IL
Mailing Address - Zip Code:61756-0521
Mailing Address - Country:US
Mailing Address - Phone:217-412-9615
Mailing Address - Fax:
Practice Address - Street 1:200 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IL
Practice Address - Zip Code:61727-3001
Practice Address - Country:US
Practice Address - Phone:217-412-9615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003291101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional