Provider Demographics
NPI:1821698184
Name:CASEY, JACINTA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JACINTA
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 MADISON AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2113
Mailing Address - Country:US
Mailing Address - Phone:410-777-8710
Mailing Address - Fax:443-434-0110
Practice Address - Street 1:940 MADISON AVE STE 202
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2113
Practice Address - Country:US
Practice Address - Phone:410-777-8710
Practice Address - Fax:443-434-0110
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker