Individual provider Active NPI

Cassidy Bret Soistman, LCSW-C

  • Social Worker
  • Salisbury, MD
National Provider Identifier
1669971040
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1411 Wesley Dr
Salisbury, MD 21801-7149
Phone
(410) 603-0596
NPI assigned
Feb 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MD Primary

Addresses

Primary practice location

1411 Wesley Dr
Salisbury, MD 21801-7149

Mailing address

1411 Wesley Dr
Salisbury, MD 21801-7149
Phone (410) 603-0596

Other names 1

  • Cassidy Bret Dolby Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240730000970 MD Practitioner - Clinical Social Worker 9032656863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23638MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Mental Wellness CurrentSince Jul 1, 2024 Accepting new patients

Locations

1411 Wesley Dr
Salisbury, MD 21801
Phone (410) 642-4011

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1669971040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 WESLEY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017149",
            "telephone_number": "410-603-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 WESLEY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017149",
            "telephone_number": "410-603-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOISTMAN",
        "first_name": "CASSIDY",
        "middle_name": "BRET",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "DOLBY",
            "middle_name": "BRET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.