JENNIE CASSIDY PSYCHOLOGIST LLC


Address: 1511 9th Ave Ste C, Conway, SC 29526-4126
Phone: 8436850264

JENNIE CASSIDY PSYCHOLOGIST LLC (NPI# 1447884705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447884705
Entity Type Organization
Organization Name JENNIE CASSIDY PSYCHOLOGIST LLC
Practice Address 1511 9th Ave Ste C
Conway
SC 29526-4126
Mailing Address 1192 Jumper Trail Cir
Myrtle Beach
SC 29588-5289
Practice Telephone 8436850264
Practice Fax Number 8437480448
Mailing Telephone 8436850264
Mailing Fax Number 8437480448
Enumeration Date 2020-02-26
Last Update Date 2020-02-26
Authorized Official Name DR. JENNIE MAY CASSIDY (PSYCHOLOGIST/OWNER)
Authorized Official Telephone 8436850264
Authorized Official Credential PHD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
SC PS0674 05

Other Provider/Organization Names

Other Name Type Code
Jennie Cassidy Psychologist LLC Doing Business As Name - Organization

Office Location

Street Address 1511 9TH AVE STE C
City CONWAY
State SC
Zip Code 29526-4126

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1598227431 Surgery Center of Conway Inc Clinic/Center 1405 Main Street, Conway, SC 29526 2019-04-01
1801374962 Trevor James Hess Specialist/Technologist 905 One Landon Loop, Conway, SC 29526 2018-08-01
1851800817 Katherine Ann Nimphius Behavioral Analyst 105 Timberline Dr, Conway, SC 29526 2017-09-21
1922544253 William Houck Specialist/Technologist 925 One Landon Loop, Conway, SC 29526 2017-01-10
1952857278 Courtney Jeanette Smith Counselor 164 Waccamaw Medical Park Dr., Conway, SC 29526 2016-08-28
1336502632 Jebediah S. Christy, D.d.s - Conway, Pllc Dentist 2756 Church St, Conway, SC 29526 2016-04-04
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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427679919 All Are Welcome Counseling Clinic/Center 2669 Pecan Ln, Conway, SC 29526-6610 2020-05-06
1619501657 Bhg L, LLC Clinic/Center 1058 Front St Ste 104, Conway, AR 72032-4337 2020-02-28
1528508108 Conway Behavioral Health, LLC Clinic/Center 2255 Sturgis Road, Conway, AR 72034-8334 2017-03-02
1669887808 Counseling and Assessment Clinic Pllc Clinic/Center 306 Salem Rd Ste 109, Conway, AR 72034-6376 2014-06-26
1417109703 Counseling Associates, Inc Clinic/Center 855 S Salem Rd, Conway, AR 72034-8365 2008-10-17
1326290610 Counseling Associates, Inc Clinic/Center 1701 Donaghey Ave, Conway, AR 72032-2511 2008-10-17
1811502271 Aich Counseling, LLC Clinic/Center 915 Oak St Ste 103, Conway, AR 72032-4389 2020-09-12
1093362881 Waccamaw Center for Mental Health Clinic/Center 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 2019-08-26
1548704521 Because You Matter Counseling Pllc Clinic/Center 21 Macarthur Dr, Conway, AR 72032-4510 2016-12-11
1730402249 Conway Regional Medical Center, Inc Clinic/Center 495 Hogan Ln Ste 2, Conway, AR 72034-8498 2010-03-11
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Competitor

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City CONWAY
Zip Code 29526

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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