Healthcare Provider Details

I. General information

NPI: 1780513788
Provider Name (Legal Business Name): CASSIE COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3935 SHERMAN AVE
SAINT JOSEPH MO
64506-3649
US

IV. Provider business mailing address

3404 E COLONY SQ
SAINT JOSEPH MO
64506-1507
US

V. Phone/Fax

Practice location:
  • Phone: 816-233-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: