Provider Demographics
NPI:1164938056
Name:THE CASEY GROUP FOR PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:THE CASEY GROUP FOR PSYCHOLOGICAL SERVICES LLC
Other - Org Name:TRICIA LEIGH CASEY, PSY.D
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:609-250-2587
Mailing Address - Street 1:601 EWING ST STE C12
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2759
Mailing Address - Country:US
Mailing Address - Phone:609-250-2587
Mailing Address - Fax:
Practice Address - Street 1:601 EWING ST STE C12
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2759
Practice Address - Country:US
Practice Address - Phone:609-250-2587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100512400103G00000X, 103TB0200X, 103TC2200X, 103TP2701X
103T00000X
NY081572103TC0700X
NJ35SI00512400103TC0700X
NJ751645103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1407012727OtherNPI