Provider Demographics
NPI:1760523872
Name:JUST, CASEY R (LCSW)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:R
Last Name:JUST
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 1:79 N. MEDICAL PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939
Mailing Address - Country:US
Mailing Address - Phone:540-213-2525
Mailing Address - Fax:540-213-2555
Practice Address - Street 1:79 N. MEDICAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939
Practice Address - Country:US
Practice Address - Phone:540-213-2525
Practice Address - Fax:540-213-2555
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040052661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC03262Medicare PIN