Provider Demographics
NPI:1336532209
Name:MCASEY, DAVID (MFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MCASEY
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 PEABODY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-6695
Mailing Address - Country:US
Mailing Address - Phone:707-446-8600
Mailing Address - Fax:530-622-2793
Practice Address - Street 1:2050 PEABODY RD STE 300
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6695
Practice Address - Country:US
Practice Address - Phone:707-446-8600
Practice Address - Fax:530-622-2793
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT27958106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist