Healthcare Provider Details

I. General information

NPI: 1558299701
Provider Name (Legal Business Name): CASEY RENEE BRANSON M.S. SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2949 FOX CHASE LN
MIDLOTHIAN VA
23112-4400
US

IV. Provider business mailing address

7374 COLTS NECK RD
MECHANICSVILLE VA
23111-4232
US

V. Phone/Fax

Practice location:
  • Phone: 804-430-3361
  • Fax:
Mailing address:
  • Phone: 804-980-5353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: