Provider Demographics
NPI:1225596091
Name:WEST, CASEY RENEE' (CADC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:RENEE'
Last Name:WEST
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21444 CARMEAN WAY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-4572
Mailing Address - Country:US
Mailing Address - Phone:302-855-1233
Mailing Address - Fax:
Practice Address - Street 1:21444 CARMEAN WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-4572
Practice Address - Country:US
Practice Address - Phone:302-855-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1611101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)