Provider Demographics
NPI:1376087338
Name:DENNIS, CASSIE (ATR-LPC)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:
Last Name:DENNIS
Suffix:
Gender:F
Credentials:ATR-LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28065
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64188-0065
Mailing Address - Country:US
Mailing Address - Phone:816-268-8501
Mailing Address - Fax:
Practice Address - Street 1:5950 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-5166
Practice Address - Country:US
Practice Address - Phone:816-268-8501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-11
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013008643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional