Provider Demographics
NPI:1750590501
Name:SAUNDERS, KASEY BRADSHAW (MS)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:BRADSHAW
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 DIRECTOR CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5996
Mailing Address - Country:US
Mailing Address - Phone:252-215-9011
Mailing Address - Fax:
Practice Address - Street 1:1025 DIRECTOR CT
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5996
Practice Address - Country:US
Practice Address - Phone:252-215-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105282Medicaid