Provider Demographics
NPI:1538166749
Name:CAHALIN, MICHAEL WILLIAM (MED)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:CAHALIN
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 CAROL ST
Mailing Address - Street 2:
Mailing Address - City:HOLT SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:65043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:605 BUSINESS LOOP 70 WEST
Practice Address - Street 2:STE 152
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203
Practice Address - Country:US
Practice Address - Phone:573-449-4770
Practice Address - Fax:573-449-4851
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:2006-04-06
Deactivation Code:
Reactivation Date:2006-06-08
Provider Licenses
StateLicense IDTaxonomies
MO2003015890101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor