Healthcare Provider Details

I. General information

NPI: 1164938056
Provider Name (Legal Business Name): THE CASEY GROUP FOR PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2017
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 EWING ST STE C12
PRINCETON NJ
08540-2759
US

IV. Provider business mailing address

601 EWING ST STE C12
PRINCETON NJ
08540-2759
US

V. Phone/Fax

Practice location:
  • Phone: 609-250-2587
  • Fax:
Mailing address:
  • Phone: 609-250-2587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number35S100512400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number35S100512400
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number081572
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00512400
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number35S100512400
License Number StateNJ
# 7
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number35S100512400
License Number StateNJ
# 8
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number751645
License Number StateNJ

VIII. Authorized Official

Name: DR. TRICIA LEIGH CASEY
Title or Position: OWNER
Credential: PSYD
Phone: 609-250-2587