Provider Demographics
NPI:1154910842
Name:TOWNSEL, CASANDRA CHANEL
Entity type:Individual
Prefix:
First Name:CASANDRA
Middle Name:CHANEL
Last Name:TOWNSEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 E NIAGARA AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-4076
Mailing Address - Country:US
Mailing Address - Phone:773-301-0496
Mailing Address - Fax:
Practice Address - Street 1:111 N ADDISON AVE STE 203
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2862
Practice Address - Country:US
Practice Address - Phone:331-209-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker