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NPI Code Detail

MEDICARE: CASS COUNTY COMMUNITY MENTAL HEALTH SERVICES

MEDICARE: CASS COUNTY COMMUNITY MENTAL HEALTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659375293
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASS COUNTY COMMUNITY MENTAL HEALTH SERVICES
Provider Business Mailing Address
First Line : 960 E STATE ST
Second Line :
City : CASSOPOLIS
State : MI
Zip : 49031-9339
Country : US
Telephone Number : 269-445-2451
Fax Number : 269-445-3216
Provider Business Practice Location Address
First Line : 960 M 60 E
Second Line :
City : CASSOPOLIS
State : MI
Zip : 49031-9339
Country : US
Telephone Number : 269-445-2451
Fax Number : 269-445-3216
Authorized Official
Title or Position : CEO
Name : MICHAEL MALLORY
Credential : LCSW
Telephone Number : 269-445-2451
Provider Enumeration Date : 06/10/2005
Last Update Date : 05/11/2026

Similar Medicare Providers

1881699593 — MISS TONYA TREZELLE COSEY MSW, LCSW
Practice Location Address:
960 E STATE ST
CASSOPOLIS, MI
49031-9339
Practice Phone: 269-445-2451
Practice Fax: 269-445-3216
1588658017 — DR. MUKTIRAJ MEHTA M.D.
Practice Location Address:
960 E STATE ST
CASSOPOLIS, MI
49031-9339
Practice Phone: 269-445-2451
Practice Fax: 269-445-3216
1629147855 — MRS. SANDRA MARKLEY LEVINE M.A., L.,L.P.
Practice Location Address:
960 E STATE ST
CASSOPOLIS, MI
49031-9339
Practice Phone: 269-445-2451
Practice Fax: 269-445-3836
1861560195 — MR. TIMOTHY CHARLES ROSENBOOM M. DIV.
Practice Location Address:
960 E STATE ST
CASSOPOLIS, MI
49031-9339
Practice Phone: 269-476-9781
Practice Fax: 269-476-9783
1831252345 — MRS. KERI A PANTALE LMSW
Practice Location Address:
960 E STATE ST
CASSOPOLIS, MI
49031-9339
Practice Phone: 269-445-2451
Practice Fax: 269-445-3836
1073676904 — MRS. RUBY MARIE RIDEOUT LMSW
Practice Location Address:
960 E STATE ST
CASSOPOLIS, MI
49031-9339
Practice Phone: 269-445-2451
Practice Fax: 269-445-3216

Directions to “CASS COUNTY COMMUNITY MENTAL HEALTH SERVICES ” Practice Location

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