Individual provider Active NPI

Cassandra Annette Pralle

  • Social Worker
  • La Crosse, WI
National Provider Identifier
1659090447
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
132767-121 Issued in WI
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

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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

LicenseStateTypeSpecialty
132767-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Spaces Counseling and Wellness, LLC CurrentSince Aug 28, 2022 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.

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.

Verify at the official NPI Registry.