| Kasey Grass PhD LLC | |
|
2401 W Grand St Springfield MO 65802-4967 | |
| (501) 993-2274 | |
| (888) 389-4091 |
| Full Name | Kasey Grass PhD LLC |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2401 W Grand St, Springfield, Missouri |
| Authorized Official Name and Position | Kasey Nicole Grass (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 5019932274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kasey Grass PhD LLC 2761 E Melbourne Rd Springfield MO 65804-5257 Ph: (501) 993-2274 | Kasey Grass PhD LLC 2401 W Grand St Springfield MO 65802-4967 Ph: (501) 993-2274 |
| NPI Number | 1942550322 |
|---|---|
| Provider Enumeration Date | 09/13/2012 |
| Last Update Date | 11/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942550322 | NPI | - | NPPES |
| 1073805909 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2011019654 (Missouri) | Primary |
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