Provider Demographics
NPI:1598263626
Name:LUMB, CASEY E (LICSW)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:E
Last Name:LUMB
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1992 OLD LOUISQUISSET PIKE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4590
Mailing Address - Country:US
Mailing Address - Phone:860-997-5417
Mailing Address - Fax:401-475-0729
Practice Address - Street 1:1992 OLD LOUISQUISSET PIKE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4590
Practice Address - Country:US
Practice Address - Phone:860-997-5417
Practice Address - Fax:401-475-0729
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW02783101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIISW02783OtherLICSW