=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609931989
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CASEY FISCHER AND ASSOCIATES LLP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 301 SOUTH DIVISION ST
-----------------------------------------------------
City | NORTHFIELD
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-650-4127
-----------------------------------------------------
Fax | 507-650-9261
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 301 SOUTH DIVISION ST
-----------------------------------------------------
City | NORTHFIELD
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-650-4127
-----------------------------------------------------
Fax | 507-650-9261
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | MARY E CASEY
-----------------------------------------------------
Credential | MA LP
-----------------------------------------------------
Telephone | 507-650-4127
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------