Healthcare Provider Details

I. General information

NPI: 1811416803
Provider Name (Legal Business Name): CASSAUNDRA LOUISE OGDEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RIVERBOAT ROW APT G7
NEWPORT KY
41071-1035
US

IV. Provider business mailing address

100 RIVERBOAT ROW APT G7
NEWPORT KY
41071-1035
US

V. Phone/Fax

Practice location:
  • Phone: 859-905-7316
  • Fax:
Mailing address:
  • Phone: 859-905-7316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1700562-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: