| Doctor Name: | MR. ROBERT R CASSIDY |
| NPI Number: | 1669619664 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LICSW |
| License Number: | 1032541 |
| Business Practice Address: | 36 Walnut St Maynard, MA - 017541759 |
| Business Phone Number: | 9782873524 |
| Business Fax Number: | 9782873539 |
| Mailing Address: | 36 Walnut St., MAYNARD |
| State: | MA |
| Postal Code: | 017541759 |
| Phone Number: | 9782873524 |
| Fax Number: | 9782873539 |
| NPI Enumeration Date: | 01/13/2009 |
| NPI Last Update Date: | 01/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1032541 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |