Healthcare Provider Details

I. General information

NPI: 1427560465
Provider Name (Legal Business Name): CASSIDY WIGAL LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 E MAIN ST
LANCASTER OH
43130-3903
US

IV. Provider business mailing address

624 E MAIN ST
LANCASTER OH
43130-3903
US

V. Phone/Fax

Practice location:
  • Phone: 740-475-0488
  • Fax:
Mailing address:
  • Phone: 740-475-0488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1901478-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: