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General NPI Number Information
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NPI Number | 1386450682
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Entity Type | Individual
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Provider Name | CASEY CHESHIRE MSW
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Gender | Male
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 3015 VETERANS PKWY S
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City | MOULTRIE
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State | GA
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Zip | 31788-6705
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Country | US
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Telephone | 229-502-9043
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Fax |
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Provider Business Mailing Address
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Address Line | 808 DAVIS AVE
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City | TIFTON
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State | GA
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Zip | 31794-4048
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Country | US
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Telephone | 229-507-5078
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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