Healthcare Provider Details

I. General information

NPI: 1316315138
Provider Name (Legal Business Name): BRIAN CASEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1593
BEVERLY HILLS CA
90213-1593
US

IV. Provider business mailing address

PO BOX 1593
BEVERLY HILLS CA
90213-1593
US

V. Phone/Fax

Practice location:
  • Phone: 424-277-3053
  • Fax:
Mailing address:
  • Phone: 617-388-2488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.026740
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number131268
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: