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General NPI Number Information
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NPI Number | 1801778287
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Entity Type | Individual
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Provider Name | JACK CASSELL MA
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Gender | Male
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 700 35TH AVE
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City | TUSCALOOSA
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State | AL
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Zip | 35401-1330
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Country | US
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Telephone | 205-758-3867
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 UNIVERSITY BLVD APT 102
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City | TUSCALOOSA
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State | AL
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Zip | 35401-1143
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Country | US
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Telephone | 407-453-2676
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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