Provider Demographics
NPI:1639822570
Name:HARRIS, CASSIE CATHERINE (LICENSED SOCIAL WORK)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:CATHERINE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LICENSED SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 W 26TH ST FL 11
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1054
Mailing Address - Country:US
Mailing Address - Phone:646-367-8512
Mailing Address - Fax:
Practice Address - Street 1:37 W 26TH ST FL 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1054
Practice Address - Country:US
Practice Address - Phone:646-367-8512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115450-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker