Provider Demographics
NPI:1619354677
Name:ENEA, CASSIE MARIE (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:CASSIE
Middle Name:MARIE
Last Name:ENEA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2520
Mailing Address - Country:US
Mailing Address - Phone:718-273-8409
Mailing Address - Fax:718-273-5265
Practice Address - Street 1:710 FOREST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2520
Practice Address - Country:US
Practice Address - Phone:347-464-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091057104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker