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General NPI Number Information
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NPI Number | 1740496447
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Entity Type | Organization
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Legal Business Name | MARY CASSADY PH.D. PLLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 11111 HALL RD SUITE 201
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City | UTICA
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State | MI
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Zip | 48317-5711
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Country | US
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Telephone | 586-254-7383
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Fax |
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Provider Business Mailing Address
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Address Line | 11111 HALL RD SUITE 201
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City | UTICA
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State | MI
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Zip | 48317-5711
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Country | US
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Telephone | 586-254-7383
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY CASSADY
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Credential | PH.D.
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Telephone | 586-254-7383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6301012228
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 6301012228
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301012228
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License Number State | MI
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