Basic Information
| Provider Information | |||||||||
| NPI: | 1437697299 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASSELLA | ||||||||
| FirstName: | KIERSTEN | ||||||||
| MiddleName: | ELISE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | BSW, LSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SNEATHEN | ||||||||
| OtherFirstName: | KIERSTEN | ||||||||
| OtherMiddleName: | ELISE | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | BSW, LSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 141 BRADY CIR W | ||||||||
| Address2: | |||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439521411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402841977 | ||||||||
| FaxNumber: | 7402841978 | ||||||||
| Practice Location | |||||||||
| Address1: | 141 BRADY CIR W | ||||||||
| Address2: | |||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439521411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402841977 | ||||||||
| FaxNumber: | 7402841978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2017 | ||||||||
| LastUpdateDate: | 12/14/2018 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | S-1500239 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.