Provider Demographics
NPI:1306394945
Name:CASEY, JENNA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 SUPERIOR LN
Mailing Address - Street 2:SUITE A6
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1923
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3231 SUPERIOR LN
Practice Address - Street 2:SUITE A6
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1923
Practice Address - Country:US
Practice Address - Phone:240-801-5568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist