Provider Demographics
NPI:1750444923
Name:CASE, MYRL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MYRL
Middle Name:
Last Name:CASE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 GRAYBURG DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-4593
Mailing Address - Country:US
Mailing Address - Phone:325-234-3284
Mailing Address - Fax:
Practice Address - Street 1:2137 OFFICE PARK DR
Practice Address - Street 2:SUITE E
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-6893
Practice Address - Country:US
Practice Address - Phone:325-234-3284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical