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Individual

CASSIE WARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
306 MAIN ST, LOGAN, WV 25601-3906
(304) 752-7707
(304) 752-0772
Mailing address
306 MAIN ST, LOGAN, WV 25601-3906
(304) 752-7707
(304) 752-0772

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1002
WV
1041C0700X
Clinical Social Worker
AP00939959
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001715139
BCBS PROVIDER NUMBER
WV
05
3810018628
WV
Enumeration date
01/11/2007
Last updated
11/08/2019
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