Provider Demographics
NPI:1316274467
Name:CASCIATO, TONJA L (LCSW)
Entity type:Individual
Prefix:
First Name:TONJA
Middle Name:L
Last Name:CASCIATO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 FREMONT ST
Mailing Address - Street 2:
Mailing Address - City:THERMOPOLIS
Mailing Address - State:WY
Mailing Address - Zip Code:82443-2915
Mailing Address - Country:US
Mailing Address - Phone:307-864-3211
Mailing Address - Fax:307-864-3267
Practice Address - Street 1:640 FREMONT ST
Practice Address - Street 2:
Practice Address - City:THERMOPOLIS
Practice Address - State:WY
Practice Address - Zip Code:82443-2915
Practice Address - Country:US
Practice Address - Phone:307-864-3211
Practice Address - Fax:307-864-3267
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical