Provider Demographics
NPI:1326546565
Name:CASSIE EATON, LLC
Entity Type:Organization
Organization Name:CASSIE EATON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:440-941-5722
Mailing Address - Street 1:330 GREENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-9186
Mailing Address - Country:US
Mailing Address - Phone:440-941-5722
Mailing Address - Fax:440-579-0135
Practice Address - Street 1:330 GREENRIDGE DR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-9186
Practice Address - Country:US
Practice Address - Phone:440-941-5722
Practice Address - Fax:440-579-0135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0392391Medicaid
OH1437334869OtherNPI
OH0256571Medicaid