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General NPI Number Information
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NPI Number | 1942019922
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Entity Type | Individual
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Provider Name | CASSIDY MARISA MOSES LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 41 CLAYTON ST # 300
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City | ASHEVILLE
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State | NC
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Zip | 28801-2423
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Country | US
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Telephone | 828-658-5013
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Fax |
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Provider Business Mailing Address
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Address Line | 900 E BROOKLYN VILLAGE AVE APT 348
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City | CHARLOTTE
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State | NC
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Zip | 28204-2998
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Country | US
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Telephone | 805-975-5087
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A20401
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License Number State | NC
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