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General NPI Number Information
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NPI Number | 1285884510
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Entity Type | Individual
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Provider Name | NOEL REGINA CASSIDY PHARMD, LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 215 S PARKSIDE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-3131
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Country | US
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Telephone | 719-327-6565
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Fax | 719-327-6566
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Provider Business Mailing Address
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Address Line | 5472 E 140TH PL
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City | THORNTON
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State | CO
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Zip | 80602-8914
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Country | US
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Telephone | 303-847-2861
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1077
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19881
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 70436
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License Number State | CA
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