Provider Demographics
NPI:1033593959
Name:NAOMI CASEMENT LMSW, CAADC LLC
Entity Type:Organization
Organization Name:NAOMI CASEMENT LMSW, CAADC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW CAADC
Authorized Official - Phone:810-964-5400
Mailing Address - Street 1:26354 WEXFORD DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48091-3991
Mailing Address - Country:US
Mailing Address - Phone:810-964-5400
Mailing Address - Fax:586-510-4800
Practice Address - Street 1:2265 LIVERNOIS RD
Practice Address - Street 2:SUITE 260
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1633
Practice Address - Country:US
Practice Address - Phone:810-964-5400
Practice Address - Fax:586-510-4800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010461121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI6820Medicare PIN