Basic Information
| Provider Information | |||||||||
| NPI: | 1457908899 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEETS | ||||||||
| FirstName: | KASSANDRA | ||||||||
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| Credential: | MSW, LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4450 LUMMISFORD LN E | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432142444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148431114 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5665 HOOVER RD | ||||||||
| Address2: | |||||||||
| City: | GROVE CITY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431239122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148752371 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2019 | ||||||||
| LastUpdateDate: | 09/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | S.1701764 | OH | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.