Provider Demographics
NPI:1871939363
Name:CASSIDY, CHELSEA LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LYNN
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5516 FALMOUTH ST
Mailing Address - Street 2:VITAS II, SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1819
Mailing Address - Country:US
Mailing Address - Phone:804-339-7418
Mailing Address - Fax:804-282-0012
Practice Address - Street 1:5516 FALMOUTH ST
Practice Address - Street 2:VITAS II, SUITE 102
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1819
Practice Address - Country:US
Practice Address - Phone:804-339-7418
Practice Address - Fax:804-282-0012
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-11
Last Update Date:2013-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040082341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical