Provider Demographics
NPI:1174764971
Name:DIRENZO, CASSIE LYNN (MSW, LISW)
Entity type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:LYNN
Last Name:DIRENZO
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 FAIRMONT STREET
Mailing Address - Street 2:PATHWAY COUNSELING CENTER, LLC
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920
Mailing Address - Country:US
Mailing Address - Phone:330-383-2961
Mailing Address - Fax:
Practice Address - Street 1:16239 SAINT CLAIR AVE
Practice Address - Street 2:PATHWAY COUNSELING CENTER, LLC
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9449
Practice Address - Country:US
Practice Address - Phone:330-386-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI07001071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical