Healthcare Provider Details

I. General information

NPI: 1992297667
Provider Name (Legal Business Name): REBECCA CASKEY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E HIGHLAND AVE STE 3
CLERMONT FL
34711-2582
US

IV. Provider business mailing address

80 S BAUER RD
LECANTO FL
34461-8078
US

V. Phone/Fax

Practice location:
  • Phone: 407-399-8855
  • Fax:
Mailing address:
  • Phone: 352-464-1076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15937
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: