Active NPI
Cassidy Wilburn
- Social Worker
- Waverly, OH
National Provider Identifier
1669977849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1701161
- Practice address
- 102 Dawn LN
Waverly, OH 45690-9695 - Phone
- (740) 947-7783
- NPI assigned
- Mar 28, 2018
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1701161 | OH | Primary |
Addresses
Primary practice location
102 Dawn LN
Waverly, OH 45690-9695
Mailing address
102 Dawn LN
Waverly, OH 45690-9695
Phone (740) 947-7783
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 |
|---|---|---|---|
| S.1701161 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522195200000",
"number": "1669977849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 DAWN LN",
"city": "WAVERLY",
"state": "OH",
"postal_code": "456909695",
"telephone_number": "740-947-7783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 DAWN LN",
"city": "WAVERLY",
"state": "OH",
"postal_code": "456909695",
"telephone_number": "740-947-7783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBURN",
"first_name": "CASSIDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-28",
"last_updated": "2018-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1701161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waverly, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.