Provider Demographics
NPI:1528002722
Name:CASEY, MEMREY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MEMREY
Middle Name:
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 1:1320 AUPAPAOHE ST.
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4138
Mailing Address - Country:US
Mailing Address - Phone:808-263-7871
Mailing Address - Fax:
Practice Address - Street 1:1320 AUPAPAOHE ST.
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4138
Practice Address - Country:US
Practice Address - Phone:808-263-7871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3038101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI22739-7OtherHMSA MEDICAL INSURANCE