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:
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Health care specialties

SpecialtyCodeLicense #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 18 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.

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Identifiers

StateTypeNumberIssuer
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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