Healthcare Provider Details

I. General information

NPI: 1023938701
Provider Name (Legal Business Name): CASSIDEE MCDONNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 COVENTRY LN
LONGMEADOW MA
01106-1629
US

IV. Provider business mailing address

171 CONVENTRY LN
EAST LONGMEADOW MA
01106
US

V. Phone/Fax

Practice location:
  • Phone: 413-461-4187
  • Fax:
Mailing address:
  • Phone: 413-641-4187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11262
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: