Active NPI
Cassandra Susan Cordova, LSW
- Clinical Social Worker
- Coon Rapids, MN
National Provider Identifier
1861279747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 199 Coon Rapids Blvd NW Ste 208
Coon Rapids, MN 55433-5860 - Phone
- (651) 269-1113
- NPI assigned
- Sep 13, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MN | Primary |
Addresses
Primary practice location
199 Coon Rapids Blvd NW Ste 208
Coon Rapids, MN 55433-5860
Mailing address
10320 Devonshire Cir Apt D212
Bloomington, MN 55431-5099
Phone (651) 269-1113
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1861279747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10320 DEVONSHIRE CIR APT D212",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554315099",
"telephone_number": "651-269-1113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "199 COON RAPIDS BLVD NW STE 208",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554335860",
"telephone_number": "651-269-1113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "CASSANDRA",
"middle_name": "SUSAN",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-13",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.