Provider Demographics
NPI:1083257596
Name:CHELSEA L. CASSIDY, LCSW, LLC
Entity Type:Organization
Organization Name:CHELSEA L. CASSIDY, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CASSIDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-339-7418
Mailing Address - Street 1:2800 N PARHAM RD STE 210
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4409
Mailing Address - Country:US
Mailing Address - Phone:804-339-7418
Mailing Address - Fax:
Practice Address - Street 1:2800 N PARHAM RD STE 210
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4409
Practice Address - Country:US
Practice Address - Phone:804-339-7418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty