Healthcare Provider Details

I. General information

NPI: 1679873020
Provider Name (Legal Business Name): RAY V. FACEY CASAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 2ND AVE FL 3
BROOKLYN NY
11215-2711
US

IV. Provider business mailing address

15 2ND AVE FL 3
BROOKLYN NY
11215-2711
US

V. Phone/Fax

Practice location:
  • Phone: 718-514-6007
  • Fax:
Mailing address:
  • Phone: 718-514-6007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number18900
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: