Provider Demographics
NPI:1215689492
Name:DARNER, CASSANDRA (LAC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:DARNER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3936 E DOVER ST APT SUITE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-6135
Mailing Address - Country:US
Mailing Address - Phone:480-612-3453
Mailing Address - Fax:
Practice Address - Street 1:690 E WARNER RD STE 115
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3056
Practice Address - Country:US
Practice Address - Phone:480-444-2434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-7224T101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health