| Doctor Name: | MS. CAROL ROSE SASSE |
| NPI Number: | 1124085196 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW-PIP |
| License Number: | 2069 |
| Business Practice Address: | 2900 Doolittle Dr Suite 1m08 Ellsworth Afb, SD - 577064821 |
| Business Phone Number: | 6053853660 |
| Business Fax Number: | 6053852030 |
| Mailing Address: | 2900 Doolittle Dr, Suite 1m08 ELLSWORTH AFB |
| State: | SD |
| Postal Code: | 577064821 |
| Phone Number: | 6053853660 |
| Fax Number: | 6053852030 |
| NPI Enumeration Date: | 04/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2069 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |