Provider Demographics
NPI:1528204583
Name:KASIK, AMY (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KASIK
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:176 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-2561
Mailing Address - Country:US
Mailing Address - Phone:508-762-1881
Mailing Address - Fax:401-332-3285
Practice Address - Street 1:176 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-2561
Practice Address - Country:US
Practice Address - Phone:508-762-1881
Practice Address - Fax:401-332-3285
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical