Cassandra Grace Smith

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

A9R138399116 Issued in WV

Practice address

1936 Russ Deberry Rd
Terra Alta, WV 26764-6663

Phone

(304) 435-7059

NPI assigned

Jun 26, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1639067697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 RUSS DEBERRY RD",
            "city": "TERRA ALTA",
            "state": "WV",
            "postal_code": "267646663",
            "telephone_number": "304-435-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 RUSS DEBERRY RD",
            "city": "TERRA ALTA",
            "state": "WV",
            "postal_code": "267646663",
            "telephone_number": "304-435-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CASSANDRA",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "WV",
            "license": "A9R138399116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Raynae Rosenberger
• Rylee Roy
• Lisa Ryan, PSYD
• Carla Denell Seigh
• Theresa Shiftlett
• Jimmy B Smith
• Kimberly Stump
• Summit Health Care, Inc
• Sammy Syruws
• Shelby Rose Tasker

• Early Intervention Provider Agency in Terra Alta, WV
• Providers in Terra Alta, WV by specialty
• Early Intervention Provider Agency in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.