Provider Demographics
NPI:1669857066
Name:KASEY & ASSOCIATES LLC
Entity Type:Organization
Organization Name:KASEY & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED CLINICAL SOCIAL WORK
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:KASEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-580-4911
Mailing Address - Street 1:230B CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:VA
Mailing Address - Zip Code:24179-3310
Mailing Address - Country:US
Mailing Address - Phone:540-580-4911
Mailing Address - Fax:
Practice Address - Street 1:4212 CYPRESS PARK DR
Practice Address - Street 2:F
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-8417
Practice Address - Country:US
Practice Address - Phone:540-400-7841
Practice Address - Fax:540-400-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040090791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty