Provider Demographics
NPI:1831487800
Name:CASEY, BRENDA JUNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:JUNE
Last Name:CASEY
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 1:624 CONCHO DR
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2117
Mailing Address - Country:US
Mailing Address - Phone:214-493-1626
Mailing Address - Fax:
Practice Address - Street 1:624 CONCHO DR
Practice Address - Street 2:
Practice Address - City:OAK POINT
Practice Address - State:TX
Practice Address - Zip Code:75068-2117
Practice Address - Country:US
Practice Address - Phone:214-493-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical