| Kaitlyn Cassidy Llc | |
|
3500 Lorain Ave Ste 300 Cleveland OH 44113-3726 | |
| (440) 864-3353 | |
| Not Available |
| Full Name | Kaitlyn Cassidy Llc |
|---|---|
| Speciality | Counselor |
| Location | 3500 Lorain Ave Ste 300, Cleveland, Ohio |
| Authorized Official Name and Position | Kaitlyn Cassidy (OWNER) |
| Authorized Official Contact | 4408643353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaitlyn Cassidy Llc 3122 W 16th St Cleveland OH 44109-1737 Ph: (440) 864-3353 | Kaitlyn Cassidy Llc 3500 Lorain Ave Ste 300 Cleveland OH 44113-3726 Ph: (440) 864-3353 |
| NPI Number | 1538932785 |
|---|---|
| Provider Enumeration Date | 10/31/2023 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Medicare PECOS PAC ID | 3577007020 |
|---|---|
| Medicare Enrollment ID | O20240626000875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538932785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Peter Arian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205582111 PECOS PAC ID: 6002258027 Enrollment ID: I20240523003753 |
| Provider Name | Kate Nagy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467838136 PECOS PAC ID: 3274077219 Enrollment ID: I20240701002620 |
| Provider Name | Seth Takacs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386120533 PECOS PAC ID: 1153869086 Enrollment ID: I20240809003193 |
| Provider Name | Rebecca Ann Serfozo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336620368 PECOS PAC ID: 3274072236 Enrollment ID: I20240822002335 |
| Provider Name | Jasmine Spradley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053882084 PECOS PAC ID: 0042750333 Enrollment ID: I20240913000266 |
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