Provider Demographics
NPI:1124251277
Name:ZONNEFELD, CASSANDRA JOY (LGSW, MSW)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JOY
Last Name:ZONNEFELD
Suffix:
Gender:F
Credentials:LGSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 BETHEL DR APT 34
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6921
Mailing Address - Country:US
Mailing Address - Phone:612-741-1328
Mailing Address - Fax:
Practice Address - Street 1:2400 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3713
Practice Address - Country:US
Practice Address - Phone:612-879-5219
Practice Address - Fax:612-879-5272
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN19029104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker