Provider Demographics
NPI:1225578214
Name:RAU, CASEY MICHELLE
Entity Type:Individual
Prefix:MS
First Name:CASEY
Middle Name:MICHELLE
Last Name:RAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 BABBIT DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3448
Mailing Address - Country:US
Mailing Address - Phone:248-953-4447
Mailing Address - Fax:
Practice Address - Street 1:5115 BABBIT DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3448
Practice Address - Country:US
Practice Address - Phone:248-953-4447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301017021103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist