Healthcare Provider Details

I. General information

NPI: 1235925579
Provider Name (Legal Business Name): CASEY HOVEY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 GREENVIEW DRIVE SE
ROCHESTER MN
55902
US

IV. Provider business mailing address

1620 GREENVIEW DRIVE SE
ROCHESTER MN
55902
US

V. Phone/Fax

Practice location:
  • Phone: 507-535-5773
  • Fax:
Mailing address:
  • Phone: 507-535-5773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4890
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: