MEDICARE: CASSIE COLLINS

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor		MO

General Provider Information

NPI Number	:	1780513788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSIE COLLINS

Provider Business Mailing Address
First Line	:	3404 E COLONY SQ
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-1507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3935 SHERMAN AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-3649
Country	:	US
Telephone Number	:	816-233-7300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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