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General NPI Number Information
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NPI Number | 1225286545
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Entity Type | Individual
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Provider Name | CASIE MICHELLE HAGANS LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 1150 E MATTHEWS AVE STE 203
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City | JONESBORO
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State | AR
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Zip | 72401-4345
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Country | US
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Telephone | 870-815-1234
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Fax | 844-232-7847
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Provider Business Mailing Address
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Address Line | 241 COUNTY ROAD 130
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City | BONO
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State | AR
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Zip | 72416-8283
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Country | US
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Telephone | 870-815-1234
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Fax | 844-232-7847
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4161-C
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License Number State | AR
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