Healthcare Provider Details

I. General information

NPI: 1891625885
Provider Name (Legal Business Name): CASEY VALLOT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MECHANIC ST
FOXBORO MA
02035-4021
US

IV. Provider business mailing address

24 WILDFLOWER RD
BARRINGTON RI
02806-5018
US

V. Phone/Fax

Practice location:
  • Phone: 508-543-2133
  • Fax:
Mailing address:
  • Phone: 401-935-9424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: