Healthcare Provider Details

I. General information

NPI: 1487240248
Provider Name (Legal Business Name): CASEY CASSADY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15802 N PARKVIEW PL
SURPRISE AZ
85374-7466
US

IV. Provider business mailing address

31194 N 138TH AVE
PEORIA AZ
85383-8038
US

V. Phone/Fax

Practice location:
  • Phone: 623-876-7000
  • Fax:
Mailing address:
  • Phone: 630-464-8549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP12831
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: