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NPI Code Detail

MEDICARE: CASEY MCKAY BROWN

MEDICARE: CASEY MCKAY BROWN
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
1101YM0800XMental Health Counselor144619CA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1770201659
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY MCKAY BROWN
Provider Business Mailing Address
First Line : 4805 GOLDEN FOOTHILL PKWY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-9651
Country : US
Telephone Number : 530-391-4411
Fax Number :
Provider Business Practice Location Address
First Line : 4805 GOLDEN FOOTHILL PKWY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-9651
Country : US
Telephone Number : 530-391-4411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2022
Last Update Date : 03/04/2026

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