Provider Demographics
NPI:1427358001
Name:CASEY, HARRIET MARCIA (LCSW)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:MARCIA
Last Name:CASEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4175 OLD WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-1240
Mailing Address - Country:US
Mailing Address - Phone:315-488-5734
Mailing Address - Fax:
Practice Address - Street 1:4175 OLD WINDING WAY
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-1240
Practice Address - Country:US
Practice Address - Phone:315-488-5734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031166-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical