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General NPI Number Information
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NPI Number | 1326546565
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Entity Type | Organization
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Legal Business Name | CASSIE EATON, LLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 330 GREENRIDGE DR
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City | GENEVA
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State | OH
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Zip | 44041-9186
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Country | US
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Telephone | 440-941-5722
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Fax | 440-579-0135
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Provider Business Mailing Address
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Address Line | 330 GREENRIDGE DR
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City | GENEVA
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State | OH
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Zip | 44041-9186
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Country | US
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Telephone | 440-941-5722
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Fax | 440-579-0135
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Authorized Official
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Title or Position | OWNER
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Name | CASSIE EATON
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Credential | LPCC
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Telephone | 440-941-5722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.1700330
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License Number State | OH
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