Booth, Cassianne Summerlin
Booth, Cassianne Summerlin is an individual health care provider with primary practice located at 708 Mobjack Pl , Newport News VA 23606-1957. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Booth, Cassianne Summerlin can be contacted via phone (757) 873-1958.Contact Information
Primary practice address
708 Mobjack Pl
Newport News VA 23606-1957
Phone: (757) 873-1958
Fax: (757) 873-2143
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0810001464 | Virginia |
Profile Details
| NPI number | 1831128339 |
|---|---|
| LBN Legal business name | Booth, Cassianne Summerlin |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831128339 | NPPES |
| Virginia | Other | 056563 | ANTHEM BC/BS |
| Virginia | Other | 080925 | ANTHEM BC/BS |
| Virginia | Other | 219661 | ANTHEM BC/BS |
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