Provider Demographics
NPI:1023770054
Name:PERMENTER, CASEY LEIGH (LCSW, CCM, CPHQ)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:LEIGH
Last Name:PERMENTER
Suffix:
Gender:F
Credentials:LCSW, CCM, CPHQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 GERMANTOWN CT STE 207
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4258
Mailing Address - Country:US
Mailing Address - Phone:901-878-3332
Mailing Address - Fax:
Practice Address - Street 1:65 GERMANTOWN CT STE 207
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4258
Practice Address - Country:US
Practice Address - Phone:901-878-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN63481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical