Healthcare Provider Details

I. General information

NPI: 1275442295
Provider Name (Legal Business Name): CASSANDRA H. MAUGHAN PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S MAIN ST STE 600
KALISPELL MT
59901-1498
US

IV. Provider business mailing address

1001 S MAIN ST STE 12972
KALISPELL MT
59901-1498
US

V. Phone/Fax

Practice location:
  • Phone: 406-219-7074
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CASSANDRA MAUGHAN
Title or Position: OWNER/PROVIDER
Credential: PMHNP-BC
Phone: 406-780-3609