Cassidy Famularo, MS, LPCC, LADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2527 Issued in MN

Practice address

900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414

Phone

(612) 706-9630

NPI assigned

Oct 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Medical Care Services, PA

  • Family Medicine Physician
  • New Brighton, MN
  • NPI 1083778708
  Medicare reassignment NPD
• Health and Wellness Collaborative

  • Clinical Psychologist
  • New Brighton, MN
  • NPI 1548822943
  NPD
• Nu-Way House Inc

  dba Nuway

  • Substance Abuse Rehabilitation Facility
  • Minneapolis, MN
  • NPI 1265515639
  NPD (past)
• Nuway Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1013608405
  NPD (past)

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1023615242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7627 10TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554234572",
            "telephone_number": "952-217-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 160",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126414",
            "telephone_number": "612-706-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMULARO",
        "first_name": "CASSIDY",
        "credential": "MS, LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304573",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairview Pharmacy Services LLC (Fairview New Brighton Pharmacy)
• Fairview Pharmacy Services LLC (Fairview New Brighton Clinic MTM)
• Michelle Faith, LICSW
• Family Support Services Inc. (Sagent Behavioral Health)
• Family Support Services Inc.
• Mohamed Farah
• Mohamud Farah
• Margaret E Faricy, R.N.
• Katelyn Victoria Fasching, MA
• Tamara Lu Felegy, M.P.T.

• Professional Counselor in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.