Healthcare Provider Details

I. General information

NPI: 1588416275
Provider Name (Legal Business Name): ANTHONY JOSEPH CASEY LCPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 N HIAWATHA AVE STE 450
CHICAGO IL
60646-4316
US

IV. Provider business mailing address

4603 N RACINE AVE APT 204
CHICAGO IL
60640-6387
US

V. Phone/Fax

Practice location:
  • Phone: 773-999-1756
  • Fax: 773-262-4841
Mailing address:
  • Phone: 224-598-6453
  • Fax: 773-961-7375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.016875
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: