Provider Demographics
NPI:1619544038
Name:BRANNIGAN, CASEY (LMHC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:BRANNIGAN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 KNUTH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4635
Mailing Address - Country:US
Mailing Address - Phone:561-402-9655
Mailing Address - Fax:
Practice Address - Street 1:200 KNUTH RD STE 101
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4635
Practice Address - Country:US
Practice Address - Phone:561-402-9655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14973101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health