Individual provider Active NPI

Cassandra Jo Soehnlen, M.A., P.C.C.

  • Professional Counselor
  • Canton, OH
National Provider Identifier
1780819789
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1200174 Issued in OH
Practice address
4641 Fulton Dr NW
Canton, OH 44718-2384
Phone
(330) 417-1799
Fax
(330) 433-1843
NPI assigned
May 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.1200174 OH Primary

Addresses

Primary practice location

4641 Fulton Dr NW
Canton, OH 44718-2384

Mailing address

4641 Fulton Dr NW
Canton, OH 44718-2384
Phone (330) 417-1799

Other identifiers 1

IdentifierTypeStateIssuer
0290822MedicaidOH

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
E.1200174OHMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1780819789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-417-1799",
            "fax_number": "330-433-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-417-1799",
            "fax_number": "330-433-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOEHNLEN",
        "first_name": "CASSANDRA",
        "middle_name": "JO",
        "credential": "M.A., P.C.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1200174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0290822",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.