MEDICARE: MRS. KASEY LYNN HAGLER MA, LPC, SCL, NCC

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	101YP2500X	Professional Counselor	6401013645	MI

General Provider Information

NPI Number	:	1730733437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KASEY LYNN HAGLER MA, LPC, SCL, NCC

Provider Business Mailing Address
First Line	:	1771 WARWICK RD SE
Second Line	:
City	:	EAST GRAND RAPIDS
State	:	MI
Zip	:	49506-4562
Country	:	US
Telephone Number	:	231-620-1357
Fax Number	:

Provider Business Practice Location Address
First Line	:	1771 WARWICK RD SE
Second Line	:
City	:	EAST GRAND RAPIDS
State	:	MI
Zip	:	49506-4562
Country	:	US
Telephone Number	:	231-620-1357
Fax Number	:

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

Provider Enumeration Date	:	07/31/2019
Last Update Date	:	07/31/2019

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