MEDICARE: TODD M CASSIDY LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	120187	MA
2	1041C0700X	Clinical Social Worker	ISW03109	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073891834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD M CASSIDY LICSW

Provider Business Mailing Address
First Line	:	10 PARK ROW W APT 635
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02903-1182
Country	:	US
Telephone Number	:	781-775-7735
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 PARK ROW W APT 635
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02903-1182
Country	:	US
Telephone Number	:	781-775-7735
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2011
Last Update Date	:	04/10/2025

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Directions to “ TODD M CASSIDY LICSW” Practice Location

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