Healthcare Provider Details

I. General information

NPI: 1760315030
Provider Name (Legal Business Name): CASSANDRA KAY PAPPAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASSANDRA KAY OLSON LADC, BSW

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 7TH AVE NW
HAYFIELD MN
55940-8897
US

IV. Provider business mailing address

206 7TH AVE NW
HAYFIELD MN
55940-8897
US

V. Phone/Fax

Practice location:
  • Phone: 507-259-1036
  • Fax:
Mailing address:
  • Phone: 507-259-1036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number307436
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: