Healthcare Provider Details

I. General information

NPI: 1003954025
Provider Name (Legal Business Name): LAURA CASEY M.A., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21885 DUNHAM RD STE. 1
CLINTON TOWNSHIP MI
48036-1030
US

IV. Provider business mailing address

21885 DUNHAM RD STE 1
CLINTON TOWNSHIP MI
48036-1030
US

V. Phone/Fax

Practice location:
  • Phone: 586-469-5955
  • Fax:
Mailing address:
  • Phone: 586-469-5955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401006716
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL912751
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: