Cassandra Eden Untiedt, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701012744 Issued in VA

Practice address

216 Hospital Ave
Marion, VA 24354-3157

Phone

(276) 783-8185

Fax

(276) 783-5030

NPI assigned

Aug 14, 2023

Sex

Female

Sole proprietor

No

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

• Mount Rogers Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wytheville, VA
  • NPI 1255365599
  Medicare reassignment Care Compare group NPD VA

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Rogers Community Services 33 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in VA

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 14, 2023.

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1093598286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 W RIDGE RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821187",
            "telephone_number": "276-223-3200",
            "fax_number": "276-223-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 HOSPITAL AVE",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243543157",
            "telephone_number": "276-783-8185",
            "fax_number": "276-783-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNTIEDT",
        "first_name": "CASSANDRA",
        "middle_name": "EDEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701012744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Town of Marion, Marion Fire/EMS
• Trinity Ambulance Service, LLC
• Trinity Ambulance Service, LLC
• Charlene M Truhlik, DC
• Natalie Elaine Tucker
• Mary Abigail Henley Vencill, PHARMD
• Samuel D Vernon, MD
• Leisa Jane Vestal, LCSW
• Virginia CVS Pharmacy LLC
• Thomas William Voglewede, OD

• All providers in Marion, VA
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.