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General NPI Number Information
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NPI Number | 1386358299
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Entity Type | Individual
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Provider Name | CASSIE MCDUFFEY LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/06/2023
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 768 WOODLAKE DR
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City | JACKSON
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State | MS
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Zip | 39206-2234
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Country | US
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Telephone | 601-500-2666
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10193
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City | JACKSON
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State | MS
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Zip | 39286-0193
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Country | US
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Telephone | 601-392-2498
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | M10425
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.109782
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License Number State | IL
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