Provider Demographics
NPI:1497012579
Name:CYR, CASEY (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:CYR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:MELANCON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:107 WAUGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5085
Mailing Address - Country:US
Mailing Address - Phone:573-874-3777
Mailing Address - Fax:573-874-3880
Practice Address - Street 1:107 WAUGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5085
Practice Address - Country:US
Practice Address - Phone:573-874-3777
Practice Address - Fax:573-874-3880
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110047771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical