Provider Demographics
NPI:1972001998
Name:MCNEW, CASSIE R
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:R
Last Name:MCNEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 FIELD DR
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-7906
Mailing Address - Country:US
Mailing Address - Phone:580-822-0025
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 152
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73702-0152
Practice Address - Country:US
Practice Address - Phone:580-234-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker