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General NPI Number Information
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NPI Number | 1891074126
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Entity Type | Individual
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Provider Name | CASEY M WESDOCK LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 26 S 2ND ST STE 101
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City | CLEARFIELD
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State | PA
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Zip | 16830-2346
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Country | US
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Telephone | 814-496-5790
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Fax |
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Provider Business Mailing Address
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Address Line | 428 OGDEN AVE
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City | CLEARFIELD
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State | PA
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Zip | 16830-2144
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Country | US
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Telephone | 814-496-5790
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW019402
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License Number State | PA
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