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Cassandre Moore, LCSW, LLC

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Company Details

Name: Cassandre Moore, LCSW, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 10 Jan 2019 (7 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 3391880
Place of Formation: IDAHO
File Number: 650046
ZIP code: 83706
County: Ada County
Principal Address: CASSANDRE MOORE STE 100 671 E RIVERPARK LN BOISE, ID 83706-4000

Agent

Name Role Address
CASSANDRE L MOORE Agent 671 EAST RIVERPARK LANE, SUITE 100, CASSANDRE MOORE, BOISE, ID 83706

Member

Name Role Address Appointed On
Ryan Sand Member 999 NORTH SLATER CREEK ROAD, BOISE, ID 83716 2024-12-23

National Provider Identifier

NPI Number:
1053879874
Certification Date:
2020-09-21

Authorized Person:

Name:
CASSANDRE MOORE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006033458 2024-12-23
Application for Reinstatement 0005663092 2024-03-29
Dissolution/Revocation - Administrative 0004240419 2021-04-08
Annual Report 0003748003 2020-01-16
Initial Filing 0003391880 2019-01-10

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Date of last update: 06 Jul 2025

Sources: Idaho Secretary of State