Robert R Cassidy, LICSW
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Maynard, MA
NPI 1669619664 · NPPES record last updated Jan 13, 2009
Key facts
- NPI
- 1669619664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 1032541 (MA)
- Practice address
- 36 Walnut St
Maynard, MA 01754-1759 - Phone
- (978) 287-3524
- Fax
- (978) 287-3539
- NPI assigned
- Jan 13, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 1032541 | MA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1032541 | MA | Yes |
| Mental Health Counselor | 101YM0800X | 1032541 | MA | |
| Professional Counselor | 101YP2500X | 1032541 | MA |
Addresses
Primary practice location
36 Walnut St
Maynard, MA 01754-1759
Mailing address
36 Walnut St.
Maynard, MA 01754-1759
Phone (978) 287-3524
Other names
- Mr. Robert R Draine
Other providers in Maynard, MA
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- Monica Bolton
- Melinda Bowens
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- Wendy Anne Calender
- Lakeetra A. Catchings
- Eileen Geralyn Cejka
- Marie Charles
- Kevin Christie
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All providers in Maynard, MA · Addiction (Substance Use Disorder) Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2009. 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.