CASSIDY BAY (NPI# 1023615242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023615242 |
| Entity Type | Individual |
| Full Name | CASSIDY BAY |
| Credential | MS, LPCC, LADC |
| Practice Address |
2118 Blaisdell Ave Minneapolis MN 55404-2415 |
| Mailing Address |
7627 10th Ave S Minneapolis MN 55423-4572 |
| Practice Telephone | 6519643675 |
| Practice Fax Number | 6128728855 |
| Mailing Telephone | 9522173291 |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
304573 | MN | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
CC02527 | MN | Behavioral Health & Social Service Providers |
| Street Address |
2118 BLAISDELL AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55404-2415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033675491 | Kristin Juntunen | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2019-02-11 |
| 1851991178 | Mary Jane Helget | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-10-27 |
| 1073111811 | Hans Hagge | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-10-14 |
| 1699373316 | Karen Ann Johnson | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-10-14 |
| 1710584024 | Norman Cox | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-10-08 |
| 1912504432 | Katie Beedle | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-10-07 |
| 1164039392 | Jennifer Harris | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-10-01 |
| 1811504459 | Alexandra Elizabeth Flatley | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-09-28 |
| 1972110906 | Emily Coughlin | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-09-24 |
| 1669088738 | Dietrich Anderson | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2020-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1760969125 | Bethany Karen Kenny | Registered Nurse | 910 E 26th St Ste 200, Minneapolis, MN 55404 | 2018-07-27 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1891299491 | Guidance Home Health Care LLC | Home Health | 2529 Nicollet Avenue 202b, Minneapolis, MN 55404 | 2018-03-20 |
| 1770085490 | Bright Future Counseling Service, LLC | Counselor | 912 E. 24th St., Suite B215, Minneapolis, MN 55404 | 2018-03-08 |
| 1346754298 | Juba Pharmacy Inc | Pharmacy | 1926 Chicago Ave S, Minneapolis, MN 55404 | 2017-11-29 |
| 1629597323 | Kira Larson Fieldstrom | Social Worker | 2400 Blaisdell Ave., Minneapolis, MN 55404 | 2017-09-13 |
| 1770008930 | Nicole Lynn Sparks | Social Worker | 2445 Park Avenue, Minneapolis, MN 55404 | 2017-08-09 |
| 1639612765 | Cosmo Home Healthcare Services, L.L.C. | Home Health | 2219 Oakland Ave S, Suite 104, Minneapolis, MN 55404 | 2016-11-21 |
| Find all providers in zip 55404 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1366056392 | Brianna Connor | Counselor | 2450 Riverside Ave Bldg Suite140, Minneapolis, MN 55454-1450 | 2020-09-08 |
| 1144831959 | Brian James Rose | Counselor | 5061 Lyndale Ave S, Minneapolis, MN 55419-1215 | 2020-08-14 |
| 1740891688 | Jennifer Twa | Counselor | 2104 Stevens Ave, Minneapolis, MN 55404-2533 | 2020-08-13 |
| 1568072254 | Marian Margaret Spiess | Counselor | 2200 1st Ave S, Minneapolis, MN 55404-3401 | 2020-08-06 |
| 1689201352 | Alyssa Mary Nyberg | Counselor | 2960 Winnetka Ave N Ste 1010, Minneapolis, MN 55427-2853 | 2020-03-24 |
| 1497392666 | Kristine Geraldine Hanson | Counselor | 2611 40th Ave S, Minneapolis, MN 55406-1862 | 2019-12-05 |
| 1265080501 | Carolyn J Niesche | Counselor | 2518 N 2nd St Ste 113, Minneapolis, MN 55411-2259 | 2019-08-29 |
| 1053966069 | Shane Jensen | Counselor | 610 22nd Ave S, Minneapolis, MN 55454-1315 | 2019-08-06 |
| 1114584760 | Lynn Marie Allar | Counselor | 2200 E Franklin Ave Ste 200a, Minneapolis, MN 55404-2395 | 2019-05-20 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55404 |
Please comment or provide details below to improve the information on CASSIDY BAY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.