Provider Demographics
NPI:1255618179
Name:PRYOR, CASEY C (MA)
Entity type:Individual
Prefix:MS
First Name:CASEY
Middle Name:C
Last Name:PRYOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 LYMAN ST
Mailing Address - Street 2:WESTBORO RECEPTION UNIT
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:288 LYMAN ST
Practice Address - Street 2:WESTBORO RECEPTION UNIT
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2633
Practice Address - Country:US
Practice Address - Phone:508-475-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-06
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health