Healthcare Provider Details

I. General information

NPI: 1124608732
Provider Name (Legal Business Name): REBECCA CASEY MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7474 SEA MANATEE ST
PARRISH FL
34219-4693
US

IV. Provider business mailing address

7474 SEA MANATEE ST
PARRISH FL
34219-4693
US

V. Phone/Fax

Practice location:
  • Phone: 727-560-0224
  • Fax:
Mailing address:
  • Phone: 727-560-0224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number133282
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18410
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number34738
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101007482
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: