Active NPI
Cassandra Annette Pralle
- Social Worker
- La Crosse, WI
National Provider Identifier
1659090447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 132767-121
- Practice address
- 605 4TH St S
La Crosse, WI 54601-4458 - Phone
- (608) 386-4160
- Fax
- (608) 615-1063
- NPI assigned
- Aug 24, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 132767-121 | WI | Primary |
Addresses
Primary practice location
605 4TH St S
La Crosse, WI 54601-4458
Mailing address
W1818 Davis Creek Rd
Mindoro, WI 54644-9416
Phone (608) 386-4160
Other practice location 1
121 W Franklin St
Sparta, WI 54656-1754
Phone (608) 386-4160
Other names 1
- Cassandra Annette Myers
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 132767-121 | WI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brave Spaces Counseling and Wellness, LLC | Current | Accepting new patients |
Locations
605 4th St S
La Crosse, WI 54601
Phone (608) 386-5495
121 W Franklin St
Sparta, WI 54656
Phone (608) 386-4160
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- La Crosse, WI
- NPI 1811580574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1659090447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W1818 DAVIS CREEK RD",
"city": "MINDORO",
"state": "WI",
"postal_code": "546449416",
"telephone_number": "608-386-4160",
"fax_number": "608-615-1063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 4TH ST S",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546014458",
"telephone_number": "608-386-4160",
"fax_number": "608-615-1063"
}
],
"practiceLocations": [
{
"address_1": "121 W Franklin St",
"address_purpose": "LOCATION",
"city": "Sparta",
"state": "WI",
"postal_code": "546561754",
"country_code": "US",
"telephone_number": "608-386-4160",
"fax_number": "608-615-1063",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRALLE",
"first_name": "CASSANDRA",
"middle_name": "ANNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-24",
"last_updated": "2022-08-24",
"certification_date": "2022-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "132767-121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CASSANDRA",
"last_name": "MYERS",
"middle_name": "ANNETTE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.