Provider Demographics
NPI:1912130816
Name:CASEY, THOMAS SEAN (MFTI)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:SEAN
Last Name:CASEY
Suffix:
Gender:M
Credentials:MFTI
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 590942
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94159-0942
Mailing Address - Country:US
Mailing Address - Phone:415-221-6655
Mailing Address - Fax:415-668-0102
Practice Address - Street 1:1735 MISSION ST
Practice Address - Street 2:C/O HAFCI
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2417
Practice Address - Country:US
Practice Address - Phone:415-746-1967
Practice Address - Fax:415-668-0102
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF #51301101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)