Individual
MRS. DIANE SUSAN CASSILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWC
Contact information
Practice address
1716 HARFORD RD, SUITE 204, FALLSTON, MD 21047-2643
(410) 877-7207
(410) 877-7224
Mailing address
1716 HARFORD RD, SUITE 204, FALLSTON, MD 21047
(410) 877-7207
(410) 877-7224
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09946
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KC83
CAREFIRST BLUE CROSS BLUE
MD
01
—
T460
BLUE CHOICE
MD
Enumeration date
05/15/2007
Last updated
03/25/2009
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