Healthcare Provider Details

I. General information

NPI: 1609027937
Provider Name (Legal Business Name): NATHAN D CASSIDY MA, LPC, LCAS, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 N CHURCH ST
GREENSBORO NC
27405-3657
US

IV. Provider business mailing address

2304 SPRING GARDEN ST. UNIT 1
GREENSBORO NC
27403
US

V. Phone/Fax

Practice location:
  • Phone: 336-272-9990
  • Fax:
Mailing address:
  • Phone: 336-303-0174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number9257
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3241
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9257
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: