Provider Demographics
NPI:1912794843
Name:JANKE, CASSITA FELECIA
Entity type:Individual
Prefix:
First Name:CASSITA
Middle Name:FELECIA
Last Name:JANKE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 WELCH DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-3049
Mailing Address - Country:US
Mailing Address - Phone:815-955-1808
Mailing Address - Fax:
Practice Address - Street 1:119 WELCH DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3049
Practice Address - Country:US
Practice Address - Phone:815-955-1808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC405300000X405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional