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).
| 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 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PS0674 | 05 |
| Other Name | Type Code |
|---|---|
| Jennie Cassidy Psychologist LLC | Doing Business As Name - Organization |
| Street Address |
1511 9TH AVE STE C |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-4126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 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 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| 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 |
| Find all providers in CONWAY | ||||
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| 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.