Provider Demographics
NPI:1316714173
Name:MCCARTY, CASSIDY PAIGE
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:PAIGE
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIV
Other - Middle Name:
Other - Last Name:MCCARTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1144 GATEWAY LOOP STE 200
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-7706
Mailing Address - Country:US
Mailing Address - Phone:541-686-5060
Mailing Address - Fax:
Practice Address - Street 1:576 OLIVE ST STE 307
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2995
Practice Address - Country:US
Practice Address - Phone:541-344-7303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health