Provider Demographics
NPI:1205523875
Name:SWEAT, CASSIDY A
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:A
Last Name:SWEAT
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CASSIDY
Other - Middle Name:A
Other - Last Name:BLANKENHORN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:528 DEIBERTS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-9117
Mailing Address - Country:US
Mailing Address - Phone:570-449-7704
Mailing Address - Fax:
Practice Address - Street 1:420 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-2143
Practice Address - Country:US
Practice Address - Phone:484-628-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027318363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health