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Individual

MS. SHELAGH MARIE CASSIDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
496 SOUTHLAND DR, LEXINGTON, KY 40503-1827
(859) 288-2425
(859) 288-7516
Mailing address
496 SOUTHLAND DR, LEXINGTON, KY 40503-1827
(859) 288-2392
(859) 721-3918

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
KY1401
KY
1041C0700X
Clinical Social Worker
Primary
KY1401
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100276590
KY
Enumeration date
08/30/2005
Last updated
05/23/2019
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