Provider Demographics
NPI:1407012727
Name:CASEY, TRICIA LEIGH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:LEIGH
Last Name:CASEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:TRICIA
Other - Middle Name:CASEY
Other - Last Name:BYARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
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:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100512400103G00000X, 103TB0200X, 103TC0700X, 103TC2200X, 103TP2701X, 103T00000X
NY081572103TC0700X
NJ751645103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
1164938056OtherNPI 2