Cassandra Susann Wilson, CDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO60316800 Issued in WA

Practice address

10828 Gravelly Lake Dr. SW
Suite 204
Lakewood, WA 98499

Phone

(253) 473-7474

Fax

(253) 474-9724

NPI assigned

Aug 7, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crossroads Treatment Center Inc

  • Addiction (Substance Use Disorder) Counselor
  • Tacoma, WA
  • NPI 1417025461
  NPD (past)
• Crossroads Treatment Center, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Lakewood, WA
  • NPI 1417397951
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1174955629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10828 GRAVELLY LAKE DR. SW",
            "address_2": "SUITE 204",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-473-7474",
            "fax_number": "253-474-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10828 GRAVELLY LAKE DR. SW",
            "address_2": "SUITE 204",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-473-7474",
            "fax_number": "253-474-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CASSANDRA",
        "middle_name": "SUSANN",
        "credential": "CDPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60316800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Rose Willshaw, LMP
• Chloe Wilmarth, LMHC
• Angela Wilson Moroney
• Antonia C Wilson
• Brynn Wilson
• Celena Wilson, PHARMD
• Chong Im Wilson, LMP
• Cynthia Wilson
• Felicia P Wilson
• James Allan Wilson, MD

• Addiction (Substance Use Disorder) Counselor in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.