Provider Demographics
NPI:1285083394
Name:CASSIDY, DAISY (LICSW)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PORTSMOUTH AVE
Mailing Address - Street 2:SUITE 1 PMB 1006
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885
Mailing Address - Country:US
Mailing Address - Phone:978-482-7571
Mailing Address - Fax:603-772-3218
Practice Address - Street 1:472 HIGH ST
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1012
Practice Address - Country:US
Practice Address - Phone:978-482-7571
Practice Address - Fax:603-772-3282
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH21541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078870Medicaid