MEDICARE: MS. CASSANDRA FAYE PRICE M.S.W., L.I.S.W.

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	I-3211	OH

General Provider Information

NPI Number	:	1588639686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CASSANDRA FAYE PRICE M.S.W., L.I.S.W.

Provider Business Mailing Address
First Line	:	3754 ANDREW AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-2319
Country	:	US
Telephone Number	:	513-531-9102
Fax Number	:	513-483-6241

Provider Business Practice Location Address
First Line	:	4050 EXECUTIVE PARK DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-2020
Country	:	US
Telephone Number	:	513-354-5675
Fax Number	:	513-483-6241

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/08/2007

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