Individual provider Active NPI

Cassandra Richardson, MA EDS

  • School Psychologist
  • Logan, WV
National Provider Identifier
1457809295
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
A3N129400126 Issued in WV
Practice address
66 School St
Logan, WV 25601-9605
Phone
(304) 792-2082
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X A3N129400126 WV Primary

Addresses

Primary practice location

66 School St
Logan, WV 25601-9605

Mailing address

66 School Street
Logan, WV 25601
Phone (304) 792-2082

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 Arts

State licenses

LicenseStateTypeSpecialty
A3N129400126WVMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1457809295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 SCHOOL STREET",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "25601",
            "telephone_number": "304-792-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SCHOOL ST",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256019605",
            "telephone_number": "304-792-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CASSANDRA",
        "name_prefix": "Mrs.",
        "credential": "MA EDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WV",
            "license": "A3N129400126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.