Healthcare Provider Details

I. General information

NPI: 1568386613
Provider Name (Legal Business Name): TODD DAVID SCOTT CASAC- T
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 ROUTE 303
BLAUVELT NY
10913
US

IV. Provider business mailing address

38 E HICKORY ST
SPRING VALLEY NY
10977-4334
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-2000
  • Fax:
Mailing address:
  • Phone: 845-269-0161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number40993
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: