MEDICARE: JANET E. CASEY MSW, LICSW

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	1041C0700X	Clinical Social Worker	04341	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	05Q34CA	OTHER	MN	BC/BS INDIVIDUAL
3	HP 25252	OTHER	MN	HEALTH PARTNERS
4	05Q33CA	OTHER	MN	BC/BS BUSINESS #
5	1016732	OTHER	MN	PREFERRED ONE
6	110586	OTHER	MN	U-CARE

General Provider Information

NPI Number	:	1295734994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET E. CASEY MSW, LICSW

Provider Business Mailing Address
First Line	:	PO BOX 352
Second Line	:
City	:	BECKER
State	:	MN
Zip	:	55308-0352
Country	:	US
Telephone Number	:	320-743-3639
Fax Number	:	320-743-4119

Provider Business Practice Location Address
First Line	:	11959 77TH ST
Second Line	:
City	:	CLEAR LAKE
State	:	MN
Zip	:	55319-9420
Country	:	US
Telephone Number	:	320-743-3639
Fax Number	:	320-743-4119

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	09/06/2008

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