Cassidy Long
Individual provider Active NPI Occupational Therapist · Bogart, GA
NPI 1629833751 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1629833751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT008541 (GA)
- Practice address
- 196 Ben Burton Cir
Bogart, GA 30622-1790 - Phone
- (678) 205-5437
- NPI assigned
- Feb 19, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT008541 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidsplay Therapy Center, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT008541 | GA | Yes |
Addresses
Primary practice location
196 Ben Burton Cir
Bogart, GA 30622-1790
Mailing address
176 Georgia Ave Apt 5
Athens, GA 30606-2781
Phone (912) 246-2426
Other providers in Bogart, GA
- Mallary King
- Kay-Leigh Crook Knight
- Ji Yoon Ko
- Kayln Tiffany Lane
- Joan Laughton
- Daniel Loper
- Jimmy Lee Loudermilk
- Nancy Lowe
- Lucy'S Personal Care LLC
- Rita Macari
All providers in Bogart, GA · Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.