Healthcare Provider Details

I. General information

NPI: 1568371904
Provider Name (Legal Business Name): CASEY DEMUNN MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 W ONEIDA ST STE 1
OSWEGO NY
13126-2670
US

IV. Provider business mailing address

257 BARKER RD
OSWEGO NY
13126-5664
US

V. Phone/Fax

Practice location:
  • Phone: 315-402-4378
  • Fax:
Mailing address:
  • Phone: 315-596-9965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. CASEY DEMUNN
Title or Position: OWNER
Credential: LMHC
Phone: 314-596-9965