Provider Demographics
NPI:1346368461
Name:MARILYN J CASSIS PHD
Entity Type:Organization
Organization Name:MARILYN J CASSIS PHD
Other - Org Name:CASSIS THERAPY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER MFT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASSIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD MFT
Authorized Official - Phone:304-345-1388
Mailing Address - Street 1:1514 KANAWHA BOULEVARD EAST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311
Mailing Address - Country:US
Mailing Address - Phone:304-345-1388
Mailing Address - Fax:
Practice Address - Street 1:1514 KANAWHA BOULEVARD EAST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311
Practice Address - Country:US
Practice Address - Phone:304-345-1388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV125101YP2500X, 106H00000X
WV965101YP2500X
WV908101YP2500X
WVCP00942504104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty