Active NPI
Colleen Marie Cassidy, LCSW
- Clinical Social Worker
- Anaheim, CA
National Provider Identifier
1619081981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS19167
- Practice address
- 1900 E la Palma Ave
Suite 101
Anaheim, CA 92805-1647 - Phone
- (714) 399-3480
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS19167 | CA | Primary |
Addresses
Primary practice location
1900 E la Palma Ave
Suite 101
Anaheim, CA 92805-1647
Mailing address
16661 Dolores St Apt B
Huntington Beach, CA 92649-3341
Phone (714) 840-7301
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS19167 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthy Mind Psychotherapy Inc | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619081981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16661 DOLORES ST APT B",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926493341",
"telephone_number": "714-840-7301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 E LA PALMA AVE",
"address_2": "SUITE 101",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928051647",
"telephone_number": "714-399-3480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSIDY",
"first_name": "COLLEEN",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS19167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.