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NPI Code Detail

MEDICARE: CASEY KAISER LEE PMHNP

MEDICARE: CASEY KAISER LEE PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner25494SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115427048OTHERCAQH

General Provider Information

NPI Number : 1013671171
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY KAISER LEE PMHNP
Provider Business Mailing Address
First Line : 871 LOWCOUNTRY BLVD
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3066
Country : US
Telephone Number : 843-501-1099
Fax Number : 843-405-2040
Provider Business Practice Location Address
First Line : 871 LOWCOUNTRY BLVD STE 200
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3096
Country : US
Telephone Number : 843-501-1099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2021
Last Update Date : 06/08/2026

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