Provider Demographics
NPI:1639698509
Name:SLEPPY, CASEY
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:SLEPPY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-0102
Mailing Address - Country:US
Mailing Address - Phone:614-592-8038
Mailing Address - Fax:614-502-5712
Practice Address - Street 1:PO BOX 102
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-0102
Practice Address - Country:US
Practice Address - Phone:614-592-8038
Practice Address - Fax:614-502-5712
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OHE.2001983-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1467210682Medicaid
OH2098386Medicaid