MEDICARE: DEANNA CASPER LMHC

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
1	101YM0800X	Mental Health Counselor	22859	FL

General Provider Information

NPI Number	:	1093580680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA CASPER LMHC

Provider Business Mailing Address
First Line	:	4149 TOWNSHIP PKWY
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-2956
Country	:	US
Telephone Number	:	561-797-8990
Fax Number	:

Provider Business Practice Location Address
First Line	:	4149 TOWNSHIP PKWY
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-2956
Country	:	US
Telephone Number	:	561-797-8990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2023
Last Update Date	:	11/24/2023

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