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NPI Code Detail

MEDICARE: CASSIE GIPSON

MEDICARE:   CASSIE  GIPSON
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
1101YM0800XMental Health Counselor04931KS

General Provider Information

NPI Number : 1821800558
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIE GIPSON
Provider Business Mailing Address
First Line : 500 N KANSAS AVE
Second Line :
City : LIBERAL
State : KS
Zip : 67901-3304
Country : US
Telephone Number : 620-604-5111
Fax Number :
Provider Business Practice Location Address
First Line : 500 N KANSAS AVE
Second Line :
City : LIBERAL
State : KS
Zip : 67901-3304
Country : US
Telephone Number : 620-604-5111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2025
Last Update Date : 01/21/2025

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Directions to “ CASSIE GIPSON ” Practice Location

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