Provider Demographics
NPI:1295461457
Name:STERLING, CASSIDY JADE (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:CASSIDY
Middle Name:JADE
Last Name:STERLING
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W KINGSTON AVE APT 310
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-6442
Mailing Address - Country:US
Mailing Address - Phone:321-482-9329
Mailing Address - Fax:
Practice Address - Street 1:120 W KINGSTON AVE APT 310
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-6442
Practice Address - Country:US
Practice Address - Phone:321-482-9329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0179731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical