Provider Demographics
NPI:1578780615
Name:CASEY, DENNIS RICHARD (MA, LCMHC)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:RICHARD
Last Name:CASEY
Suffix:
Gender:M
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 EASTERN AVE
Mailing Address - Street 2:P.O. BOX 4016
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-5606
Mailing Address - Country:US
Mailing Address - Phone:802-748-3868
Mailing Address - Fax:802-748-5416
Practice Address - Street 1:190 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-5606
Practice Address - Country:US
Practice Address - Phone:802-748-3868
Practice Address - Fax:802-748-5416
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000038101YA0400X
VT068-0000369101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health