Provider Demographics
NPI:1215753603
Name:SILVANIMA, CASSIE ANN
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:ANN
Last Name:SILVANIMA
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 1:1618 APAKIN NENE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4723
Mailing Address - Country:US
Mailing Address - Phone:850-321-5658
Mailing Address - Fax:
Practice Address - Street 1:136 OAKWOOD TRCE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-3300
Practice Address - Country:US
Practice Address - Phone:229-227-2535
Practice Address - Fax:229-227-2142
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW012157104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker