Active NPI
Colleen Cassidy, M. ED.
- Early Intervention Provider Agency
- Alexandria, VA
National Provider Identifier
1184198764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- License
- 13989
- Practice address
- 4326 Duke St
Alexandria, VA 22304-2528 - Phone
- (703) 346-1836
- NPI assigned
- Jan 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 13989 | VA | Primary |
Addresses
Primary practice location
4326 Duke St
Alexandria, VA 22304-2528
Mailing address
4326 Duke St
Alexandria, VA 22304-2528
Phone (703) 346-1836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13989 | VA | MD | Early Intervention Provider Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1184198764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4326 DUKE ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223042528",
"telephone_number": "703-346-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4326 DUKE ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223042528",
"telephone_number": "703-346-1836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSIDY",
"first_name": "COLLEEN",
"credential": "M. ED.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "VA",
"license": "13989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.