Provider Demographics
NPI:1437334869
Name:EATON, CASSIE AMANDA (LPCC)
Entity Type:Individual
Prefix:MS
First Name:CASSIE
Middle Name:AMANDA
Last Name:EATON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:CASSIE
Other - Middle Name:AMANDA
Other - Last Name:FEDOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RC
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
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional