Basic Information
| Provider Information | |||||||||
| NPI: | 1841924735 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEGER | ||||||||
| FirstName: | CASSIE | ||||||||
| MiddleName: | CHRISTIN | ||||||||
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| Credential: | LLMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 703 LIVERNOIS ST | ||||||||
| Address2: | |||||||||
| City: | FERNDALE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482202306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2489553219 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 703 LIVERNOIS ST | ||||||||
| Address2: | |||||||||
| City: | FERNDALE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482202306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2489553219 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2022 | ||||||||
| LastUpdateDate: | 07/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | 6851107560 | MI | N | Behavioral Health & Social Service Providers | Social Worker | School | 1041C0700X | 6851107560 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.