Provider Demographics
NPI:1619731635
Name:CASEY, KAROL FRANCES
Entity Type:Individual
Prefix:MS
First Name:KAROL
Middle Name:FRANCES
Last Name:CASEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 DELTA PARK DR APT 7
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3695
Mailing Address - Country:US
Mailing Address - Phone:646-319-7792
Mailing Address - Fax:
Practice Address - Street 1:158 DELTA PARK DR APT 7
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3695
Practice Address - Country:US
Practice Address - Phone:646-319-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NCP-18966104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty