Healthcare Provider Details

I. General information

NPI: 1023989027
Provider Name (Legal Business Name): ANNEASHIA COLLINS CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 6TH ST
MALONE NY
12953-1246
US

IV. Provider business mailing address

324 COUNTY ROUTE 51 BLDG 1
MALONE NY
12953-4502
US

V. Phone/Fax

Practice location:
  • Phone: 518-483-3261
  • Fax: 518-483-3383
Mailing address:
  • Phone: 518-483-1251
  • Fax: 518-483-2242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: