Provider Demographics
NPI:1518435445
Name:CASEY, ANGIE (LPC)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 SYLVESTER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3837
Mailing Address - Country:US
Mailing Address - Phone:314-626-0247
Mailing Address - Fax:
Practice Address - Street 1:342 SYLVESTER AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-3837
Practice Address - Country:US
Practice Address - Phone:314-626-0247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health