Provider Demographics
NPI:1952973828
Name:CASEY MACGREGOR-TOSHIMA LCSW PC
Entity Type:Organization
Organization Name:CASEY MACGREGOR-TOSHIMA LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MACGREGOR TOSHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LCSW
Authorized Official - Phone:917-969-3009
Mailing Address - Street 1:494 AVENUE 64
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2257
Mailing Address - Country:US
Mailing Address - Phone:917-969-3009
Mailing Address - Fax:
Practice Address - Street 1:494 AVENUE 64
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2257
Practice Address - Country:US
Practice Address - Phone:917-969-3009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty