Healthcare Provider Details

I. General information

NPI: 1063969996
Provider Name (Legal Business Name): CASSIE ST. AUBIN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASSIE MORAN TLMHC

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 IOWA AVE
MADRID IA
50156-7301
US

IV. Provider business mailing address

608 CARROLL ST STE A
BOONE IA
50036-2845
US

V. Phone/Fax

Practice location:
  • Phone: 515-291-3627
  • Fax:
Mailing address:
  • Phone: 515-291-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: