Provider Demographics
NPI:1063017853
Name:BARRETT, KASSIDY (LSW)
Entity Type:Individual
Prefix:
First Name:KASSIDY
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROSS PARK BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2671
Mailing Address - Country:US
Mailing Address - Phone:740-264-7751
Mailing Address - Fax:
Practice Address - Street 1:1 ROSS PARK BLVD STE 201
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2671
Practice Address - Country:US
Practice Address - Phone:740-264-7751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2005274104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker