Provider Demographics
NPI:1467110429
Name:PRICE, CASEY
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 STRADER DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-4090
Mailing Address - Country:US
Mailing Address - Phone:859-899-9200
Mailing Address - Fax:
Practice Address - Street 1:916 RED HOUSE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-9326
Practice Address - Country:US
Practice Address - Phone:859-267-1144
Practice Address - Fax:859-267-1444
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator