Healthcare Provider Details

I. General information

NPI: 1952022626
Provider Name (Legal Business Name): CASIE JAMESON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OPC 557 BOX 57
FPO AP
96371-9001
US

IV. Provider business mailing address

3D MEDICAL BATTALION OPC 557 BOX 57
FPO AP
96371-9001
US

V. Phone/Fax

Practice location:
  • Phone: 315-645-9564
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810008374
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: