Provider Demographics
NPI:1912444308
Name:MENDEZ, CASSANDRA (LICSW)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:SIMPKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3311 PINNACLE LN
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-9844
Mailing Address - Country:US
Mailing Address - Phone:509-521-3348
Mailing Address - Fax:
Practice Address - Street 1:719 JADWIN AVE # 17
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4217
Practice Address - Country:US
Practice Address - Phone:509-521-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW613766671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical