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NPI Code Detail

MEDICARE: CASEY LYNN REDPATH

MEDICARE: CASEY LYNN REDPATH
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1134790868
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY LYNN REDPATH
Provider Business Mailing Address
First Line : 75 OLD FARM RD
Second Line :
City : NEEDHAM
State : MA
Zip : 02492-4147
Country : US
Telephone Number : 617-513-4724
Fax Number :
Provider Business Practice Location Address
First Line : 300 SOUTH ST
Second Line :
City : CHESTNUT HILL
State : MA
Zip : 02467-3694
Country : US
Telephone Number : 617-676-3368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2021
Last Update Date : 07/03/2021

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