Provider Demographics
NPI:1922137520
Name:CASEY, JAMEELIYAH LANE (MA)
Entity Type:Individual
Prefix:MRS
First Name:JAMEELIYAH
Middle Name:LANE
Last Name:CASEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JAMEELIYAH
Other - Middle Name:DAWAN
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1728 FLAGSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-1712
Mailing Address - Country:US
Mailing Address - Phone:931-206-0976
Mailing Address - Fax:
Practice Address - Street 1:810 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-4068
Practice Address - Country:US
Practice Address - Phone:931-206-0976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool