| Cassandra Sissom, LPC, LCPC | |
|
1063 S State Route 157 Ste 2-128, Edwardsville, IL 62025-3695 | |
| (618) 515-5890 | |
| (866) 423-9057 |
| Full Name | Cassandra Sissom |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1063 S State Route 157 Ste 2-128, Edwardsville, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427460906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2016036039 (Missouri) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220414000139 |
| Mailing Address | Practice Location Address |
|---|---|
| Cassandra Sissom, LPC, LCPC 103 Pine Hollow Ln, Collinsville, IL 62234-4784 Ph: (314) 479-4564 | Cassandra Sissom, LPC, LCPC 1063 S State Route 157 Ste 2-128, Edwardsville, IL 62025-3695 Ph: (618) 515-5890 |
Kaitlyn Koniuszy, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 40b Edwardsville Prof Park, Edwardsville, IL 62025 Phone: 618-248-2040 Fax: 618-248-2040 | |
Ms. Montana Sky Brown, L.C.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Club Centre Ct, Suite 1, Edwardsville, IL 62025 Phone: 618-789-0115 Fax: 618-656-9084 | |
Kendahl Cambridge, Counselor Medicare: Not Enrolled in Medicare Practice Location: 131 Hillsboro Ave, Edwardsville, IL 62025 Phone: 314-246-0851 | |
Ms. Yvonne M Mccall, MA, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 671 Orchard St, Edwardsville, IL 62025 Phone: 618-656-9208 | |
Mr. James O Kapp, BA CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 Hillsboro Ave, Suite 200, Edwardsville, IL 62025 Phone: 618-296-5220 Fax: 618-659-1185 | |
Megan Denton, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 40b Edwardsville Prof Park, Edwardsville, IL 62025 Phone: 618-248-2040 Fax: 618-248-2040 | |
Jennifer K. Payne, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 131 Hillsboro Ave, Edwardsville, IL 62025 Phone: 618-417-7132 |