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General NPI Number Information
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NPI Number | 1114539061
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Entity Type | Organization
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Legal Business Name | CASEY MCCARRAGHER LLC
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 14135 N CEDARBURG RD
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City | MEQUON
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State | WI
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Zip | 53097-1416
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Country | US
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Telephone | 262-377-2006
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Fax |
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Provider Business Mailing Address
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Address Line | 8564 N 56TH ST
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City | BROWN DEER
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State | WI
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Zip | 53223-3022
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Country | US
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Telephone | 414-412-7459
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | CASEY MCCARRAGHER
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Credential | LCSW
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Telephone | 414-412-7459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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