Individual provider Active NPI

Cassidy C Arnold, PHD

  • Clinical Psychologist
  • Mount Pleasant, SC
National Provider Identifier
1013407493
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1447 Issued in SC
Practice address
1459 Stuart Engals Blvd Ste 204-a
Mt Pleasant, SC 29464-3600
Phone
(843) 849-9913
Fax
(843) 881-6878
NPI assigned
May 11, 2018
Last updated
May 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1447 SC Primary

Addresses

Primary practice location

1459 Stuart Engals Blvd Ste 204-a
Mt Pleasant, SC 29464-3600

Mailing address

1459 Stuart Engals Blvd Ste 204-a
Mt Pleasant, SC 29464-3600
Phone (843) 849-9913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180731003040 SC Practitioner - Clinical Psychologist 9032467576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

1422 Ashley River Rd
Charleston, SC 29407-5306
Phone (843) 501-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1447SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Counseling Center PC CurrentSince May 11, 2023 Accepting new patients
Charleston Neuropsychology LLC Clinical CurrentSince May 25, 2018 Accepting new patients
Myrtle Beach Counseling Center PastSince Aug 6, 2019 Accepting new patients

Locations

1422 Ashley River Rd
Charleston, SC 29407
Phone (843) 573-9333

1459 Stuart Engals Blvd
Ste 204A
Mt Pleasant, SC 29464
Phone (843) 849-9913

1459 Stuart Engals Blvd
Unit 204
Mt Pleasant, SC 29464
Phone (843) 849-9913

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

4000 Faber Place Dr
Ste 110
North Charleston, SC 29405
Phone (833) 803-1894

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1013407493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 STUART ENGALS BLVD STE 204-A",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643600",
            "telephone_number": "843-849-9913",
            "fax_number": "843-881-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 STUART ENGALS BLVD STE 204-A",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643600",
            "telephone_number": "843-849-9913",
            "fax_number": "843-881-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "CASSIDY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-11",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.