Provider Demographics
NPI:1245792217
Name:HENNEKE, CASEY (MA, LPC)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:HENNEKE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11553 FM 1726
Mailing Address - Street 2:
Mailing Address - City:GOLIAD
Mailing Address - State:TX
Mailing Address - Zip Code:77963-3810
Mailing Address - Country:US
Mailing Address - Phone:361-645-0245
Mailing Address - Fax:
Practice Address - Street 1:11553 FM 1726
Practice Address - Street 2:
Practice Address - City:GOLIAD
Practice Address - State:TX
Practice Address - Zip Code:77963-3810
Practice Address - Country:US
Practice Address - Phone:361-722-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health