Provider Demographics
NPI:1801156898
Name:THIGPEN, CASSIDY NICOLE (MS)
Entity type:Individual
Prefix:MS
First Name:CASSIDY
Middle Name:NICOLE
Last Name:THIGPEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N BELAIR SQ STE 3
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4322
Mailing Address - Country:US
Mailing Address - Phone:706-833-0780
Mailing Address - Fax:844-880-3086
Practice Address - Street 1:601 N BELAIR SQ STE 3
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4322
Practice Address - Country:US
Practice Address - Phone:706-833-0780
Practice Address - Fax:844-880-3086
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor