Individual
CASSANDRA GAYLE CAUDILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
30 MEDPARK SQUARE DR STE 2&3, SOMERSET, KY 42503-1709
(833) 510-4357
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
271277
KY
101YP2500X
Professional Counselor
Primary
284257
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100762610
—
KY
Enumeration date
06/21/2019
Last updated
02/27/2024
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