Carly A Cassidy

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC61477354 Issued in WA

Practice address

245 E South Boulder Rd # D326
Lafayette, CO 80026-2917

Phone

(425) 829-8132

NPI assigned

Aug 30, 2023

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1285419895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 SQUAK MOUNTAIN LOOP SW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980274416",
            "telephone_number": "425-829-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E SOUTH BOULDER RD # D326",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262917",
            "telephone_number": "425-829-8132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6505 216th St SW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mountlake Terrace",
            "state": "WA",
            "postal_code": "980432089",
            "country_code": "US",
            "telephone_number": "425-640-7009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "CARLY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2024-01-11",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0018109",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61477354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Carwin, MD
• Melissa Ragen Bobic Case, RN
• Robert Caspari, MD
• Shane Paul Cass, DO
• Joseph E Cassara, M.D.
• Brenda Cattoor
• Carol Jane Caudill, P. T.
• Wesley Michael Cavanaugh, D.C.
• Matthew Cavanna
• Centaur Pharmacy

• Mental Health Counselor in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.