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General NPI Number Information
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NPI Number | 1841403045
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Entity Type | Individual
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Provider Name | MELISSA MARIE CASSIDAY LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 12/06/2022
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Provider Practice Location Address
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Address Line | 2387 E. WALTON BLVD
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City | AUBURN HILLS
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State | MI
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Zip | 48326
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Country | US
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Telephone | 248-475-6307
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Fax |
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Provider Business Mailing Address
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Address Line | 1177 WINDSOR ST
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City | FLINT
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State | MI
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Zip | 48507-4261
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Country | US
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Telephone | 616-821-3934
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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 | 6801085872
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License Number State | MI
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