Healthcare Provider Details

I. General information

NPI: 1538166749
Provider Name (Legal Business Name): MICHAEL WILLIAM CAHALIN MED
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date: 04/06/2006
Reactivation Date: 06/08/2006

III. Provider practice location address

605 BUSINESS LOOP 70 WEST STE 152
COLUMBIA MO
65203
US

IV. Provider business mailing address

1729 CAROL ST
HOLT SUMMIT MO
65043
US

V. Phone/Fax

Practice location:
  • Phone: 573-449-4770
  • Fax: 573-449-4851
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2003015890
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2003015890
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: