MEDICARE: MR. DAVID JOHN CASEY M.ED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor	378038	MA

General Provider Information

NPI Number	:	1538765656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID JOHN CASEY M.ED

Provider Business Mailing Address
First Line	:	21 CLIFF DR
Second Line	:
City	:	NORTH ATTLEBORO
State	:	MA
Zip	:	02760-3507
Country	:	US
Telephone Number	:	617-543-7396
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 CLIFF DR
Second Line	:
City	:	NORTH ATTLEBORO
State	:	MA
Zip	:	02760-3507
Country	:	US
Telephone Number	:	617-543-7396
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2020
Last Update Date	:	12/05/2020

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