Provider Demographics
NPI:1780321240
Name:LAWRENCE, CASSIDY CLOER (LCSW-A)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:CLOER
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:CASSIDY
Other - Middle Name:
Other - Last Name:CLOER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-A
Mailing Address - Street 1:200 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4358
Mailing Address - Country:US
Mailing Address - Phone:704-874-1936
Mailing Address - Fax:704-565-4614
Practice Address - Street 1:4555 OGBURN AVE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-2726
Practice Address - Country:US
Practice Address - Phone:336-703-4273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0170701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical