Healthcare Provider Details

I. General information

NPI: 1457938649
Provider Name (Legal Business Name): MAILE CASEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NOYES ST
UTICA NY
13502-3852
US

IV. Provider business mailing address

1400 NOYES ST
UTICA NY
13502-3852
US

V. Phone/Fax

Practice location:
  • Phone: 315-738-2657
  • Fax: 315-738-4410
Mailing address:
  • Phone: 315-738-2657
  • Fax: 315-738-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number097505
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: