Provider Demographics
NPI:1790591634
Name:HAGEL, CASSIDY JADE (MSW, LICSWA)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:JADE
Last Name:HAGEL
Suffix:
Gender:F
Credentials:MSW, LICSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 N WALL ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1166
Mailing Address - Country:US
Mailing Address - Phone:509-991-3934
Mailing Address - Fax:
Practice Address - Street 1:9921 N NEVADA ST STE 103
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1145
Practice Address - Country:US
Practice Address - Phone:509-606-0588
Practice Address - Fax:509-593-8113
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61331390101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health