Provider Demographics
NPI:1093302804
Name:DEAR, CASSIDY (LMSW)
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:DEAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 PROVIDENCE MAIN ST NW APT 78
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-2646
Mailing Address - Country:US
Mailing Address - Phone:773-218-7229
Mailing Address - Fax:
Practice Address - Street 1:7540 MEMORIAL PKWY SW STE W
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2208
Practice Address - Country:US
Practice Address - Phone:256-824-9171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5226G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker