Healthcare Provider Details

I. General information

NPI: 1952109597
Provider Name (Legal Business Name): CASSIDY SHARPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASSIDY DALIYA SHARPER

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 E PARK AVE
NILES OH
44446-2352
US

IV. Provider business mailing address

2001 WARWICK AVE
YOUNGSTOWN OH
44505-4386
US

V. Phone/Fax

Practice location:
  • Phone: 330-544-8005
  • Fax:
Mailing address:
  • Phone: 330-907-2515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2607984
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: