Provider Demographics
NPI:1275703589
Name:ROOT-CARON, CASEY M (LMHC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:M
Last Name:ROOT-CARON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12903-4908
Mailing Address - Country:US
Mailing Address - Phone:518-565-4060
Mailing Address - Fax:518-566-0168
Practice Address - Street 1:130 ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12903-4908
Practice Address - Country:US
Practice Address - Phone:518-565-4060
Practice Address - Fax:518-566-0168
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY004615101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health