Provider Demographics
NPI:1376548321
Name:CASHON, MARILYN (LP, LPC)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:CASHON
Suffix:
Gender:F
Credentials:LP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 W EDGEWOOD DR
Mailing Address - Street 2:STE C
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-6891
Mailing Address - Country:US
Mailing Address - Phone:573-761-4340
Mailing Address - Fax:573-761-4478
Practice Address - Street 1:3308 W EDGEWOOD DR
Practice Address - Street 2:STE C
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-6891
Practice Address - Country:US
Practice Address - Phone:573-761-4340
Practice Address - Fax:573-761-4478
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002013101YP2500X
MO01782103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO105760OtherBLUE CROSS BLUE SHIELD