Healthcare Provider Details

I. General information

NPI: 1295674844
Provider Name (Legal Business Name): CASSIDY ALEXANDRIA GOULD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26777 LORAIN RD STE 317
NORTH OLMSTED OH
44070-3225
US

IV. Provider business mailing address

617 N MAIN ST UPPR
NORTH CANTON OH
44720-2006
US

V. Phone/Fax

Practice location:
  • Phone: 216-389-4098
  • Fax:
Mailing address:
  • Phone: 513-500-0991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: