Organization
JENNIE CASSIDY PSYCHOLOGIST LLC
Active
Other names
Jennie Cassidy Psychologist LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIE MAY CASSIDY PHD (PSYCHOLOGIST/OWNER)
(843) 685-0264
Entity
Organization
Contact information
Practice address
1511 9TH AVE STE C, CONWAY, SC 29526-4126
(843) 685-0264
(843) 748-0448
Mailing address
1192 JUMPER TRAIL CIR, MYRTLE BEACH, SC 29588-5289
(843) 685-0264
(843) 748-0448
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0674
—
SC
Enumeration date
02/26/2020
Last updated
02/26/2020
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