Provider Demographics
NPI:1114797222
Name:SLOOP, CASSIE LYNN (LCMHCA)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:LYNN
Last Name:SLOOP
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 STELLA CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-0045
Mailing Address - Country:US
Mailing Address - Phone:704-254-0745
Mailing Address - Fax:
Practice Address - Street 1:1201 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-2907
Practice Address - Country:US
Practice Address - Phone:980-425-3756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19563101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health