Provider Demographics
NPI:1417371865
Name:DEMOS, CASSIDY (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:DEMOS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CASSIDY
Other - Middle Name:
Other - Last Name:DREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10400 STEVENSON RD
Mailing Address - Street 2:SUITE 201-5 P.O. BOX 228
Mailing Address - City:STEVENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21153-0600
Mailing Address - Country:US
Mailing Address - Phone:410-561-3651
Mailing Address - Fax:
Practice Address - Street 1:10400 STEVENSON RD
Practice Address - Street 2:SUITE 201-5
Practice Address - City:STEVENSON
Practice Address - State:MD
Practice Address - Zip Code:21153-0600
Practice Address - Country:US
Practice Address - Phone:410-561-3651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical