Healthcare Provider Details

I. General information

NPI: 1134055452
Provider Name (Legal Business Name): CASSADI CHRISTENSON LCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 OLIVE BLVD STE 176
CREVE COEUR MO
63141-7147
US

IV. Provider business mailing address

3 OAK DR STE B
MARYVILLE IL
62062-5635
US

V. Phone/Fax

Practice location:
  • Phone: 618-974-5815
  • Fax: 618-205-3561
Mailing address:
  • Phone: 618-974-5815
  • Fax: 618-205-3561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026028184
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: