Provider Demographics
NPI:1750582789
Name:CASDEN, STACY A (CASAC)
Entity type:Individual
Prefix:MS
First Name:STACY
Middle Name:A
Last Name:CASDEN
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-2602
Mailing Address - Country:US
Mailing Address - Phone:845-353-3656
Mailing Address - Fax:
Practice Address - Street 1:620 ROUTE 303
Practice Address - Street 2:
Practice Address - City:BLAUVELT
Practice Address - State:NY
Practice Address - Zip Code:10913-1170
Practice Address - Country:US
Practice Address - Phone:845-353-2730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8261101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)