Provider Demographics
NPI:1568287191
Name:SCOTT, CASSADY PRISCILLA (CADC-INTERN)
Entity type:Individual
Prefix:
First Name:CASSADY
Middle Name:PRISCILLA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CADC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E FLAMINGO RD STE 218
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5124
Mailing Address - Country:US
Mailing Address - Phone:702-463-7719
Mailing Address - Fax:702-463-3145
Practice Address - Street 1:2121 E FLAMINGO RD STE 218
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5124
Practice Address - Country:US
Practice Address - Phone:702-463-7719
Practice Address - Fax:702-463-3145
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV07154-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)