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NPI Code Detail

MEDICARE: CASSANDRA ROSHELL MCNEESE PCAT, MS, MSW

MEDICARE: CASSANDRA ROSHELL MCNEESE PCAT, MS, MSW
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1285148999
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA ROSHELL MCNEESE PCAT, MS, MSW
Provider Business Mailing Address
First Line : 860 E RIVER PL STE 100
Second Line :
City : JACKSON
State : MS
Zip : 39202-3442
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 428 24TH AVE N
Second Line :
City : COLUMBUS
State : MS
Zip : 39705-1945
Country : US
Telephone Number : 662-241-7097
Fax Number : 662-245-0511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2017
Last Update Date : 11/17/2017

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