Healthcare Provider Details

I. General information

NPI: 1801041249
Provider Name (Legal Business Name): JOHN PATRICK CASEY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2008
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 HOSPITAL DRIVE
ATHENS OH
45701
US

IV. Provider business mailing address

90 HOSPITAL DRIVE
ATHENS OH
45701
US

V. Phone/Fax

Practice location:
  • Phone: 740-594-5045
  • Fax: 740-594-5642
Mailing address:
  • Phone: 740-594-5045
  • Fax: 740-594-5642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC. 0005038
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: