DR. JENNIE MAY CASSIDY (NPI# 1184752495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184752495 |
| Entity Type | Individual |
| Full Name | DR. JENNIE MAY CASSIDY |
| Credential | PH.D. |
| Practice Address |
204 University Blvd. Coastal Carolina University Conway SC 29528-6054 |
| Mailing Address |
280 Barclay Dr Myrtle Beach SC 29579-6572 |
| Practice Telephone | 8433492305 |
| Practice Fax Number | 8433492898 |
| Mailing Telephone | 8436852125 |
| Mailing Fax Number | 8433492898 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | 1042 | SC | Behavioral Health & Social Service Providers |
| X | 103TC1900X |
Psychologist Specialization: Counseling |
1042 | SC | Behavioral Health & Social Service Providers |
| X | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
1042 | SC | Behavioral Health & Social Service Providers |
| Street Address |
204 UNIVERSITY BLVD. COASTAL CAROLINA UNIVERSITY |
| City | CONWAY |
| State | SC |
| Zip Code | 29528-6054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780718130 | Coastal Carolina University Counseling Services | Community/Behavioral Health | 204 University Blvd., Conway, SC 29528-6054 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538496682 | Jeffrey Pounds | Specialist/Technologist | 107 Tom Trout Dr. Wb 106, Coastal Carolina University, Conway, SC 29528 | 2009-11-11 |
| 1003034331 | Kel Z Gaskin Prock | Occupational Therapist | 335 Four Mile Road, Conway, SC 29528 | 2007-04-23 |
| 1801316112 | Meghan Campbell | Specialist/Technologist | 935 One Landon Loop, Conway, SC 29528 | 2017-06-27 |
| 1093144966 | Alicia Adcock | Speech-Language Pathologist | 335 Four Mile Road, Post Office Box 260005, Conway, SC 29528 | 2013-11-01 |
| 1164828729 | Shoreline Behavioral Health Services | Community/Behavioral Health | 2404 Wise Road, Conway, SC 29528-0136 | 2014-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851191 | Angie Mae Johnson | Pharmacist | 1250 S Amity Rd, Conway, AR 72032-8732 | 2020-11-07 |
| 1992305866 | Pamela Robinson | Psychologist | 176a Main St, Conway, NH 03818-6164 | 2020-10-29 |
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1023617594 | Mckenzie Lauren Cotton | Nurse Practitioner | 1065 Skyline Dr, Conway, AR 72032-3530 | 2020-10-25 |
| 1790384808 | Prime Medical Group Pllc | Dermatology | 625 United Dr Ste 320, Conway, AR 72032-7828 | 2020-10-20 |
| 1932706363 | Kassie Wiest | Chiropractor | 1855 Mckennon St Ste 300, Conway, AR 72032-2840 | 2020-10-08 |
| 1710584842 | True Care Home Care LLC | Home Health | 900b Main St Ste 201, Conway, SC 29526-4063 | 2020-10-01 |
| 1033726922 | Alicia Landry | Dietitian, Registered | 201 Donaghey Ave, Mcalister 100, Conway, AR 72035 | 2020-09-25 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1508471509 | Access Counseling & Assessment Services, LLC | Counselor | 505 Amity Rd Ste 604, Conway, AR 72032-5993 | 2020-09-15 |
| Find all providers in CONWAY | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629426770 | Nicholas Mitrani | Psychologist | 4206 Prince Street, Conway, AR 72034-9398 | 2016-05-31 |
| 1255697330 | Conway Psychological Assessment Center | Psychologist | 1210 Hogan Ln, Suite 200, Conway, AR 72034-8001 | 2012-04-03 |
| 1851667349 | Melissa Moix | Psychologist | 1210 Hogan Ln Ste 200, Conway, AR 72034-8063 | 2012-03-28 |
| 1255564803 | Chrystal Lynne Johnston | Psychologist | 710 S Country Club Rd, Conway, AR 72034-9307 | 2009-08-31 |
| 1265527238 | William Edward Siegel | Psychologist | 3135 Tyler St, Conway, AR 72034-3456 | 2006-10-04 |
| 1336241223 | William Tadashi Nagahiro | Psychologist | 30 Pleasant St, Conway, NH 03818-2265 | 2006-09-02 |
| 1083716021 | Susan E Schaefer | Psychologist | 350 Salem Road, Suite 1, Conway, AR 72034 | 2006-09-01 |
| 1114578903 | Sarah Lindeman Root | Psychologist | 1100 Bob Courtway Dr Ste 9, Conway, AR 72032-4767 | 2019-09-24 |
| 1770082349 | Samantha Bellini | Psychologist | 81 Washington St, Conway, NH 03818 | 2018-02-08 |
| 1477965374 | Lori Dunaway | Psychologist | 1014 Main St, Conway, AR 72032-5426 | 2014-05-27 |
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| 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.