MEDICARE: MS. ROSE M. CASEY L.P.C.

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	LPC 2271	AZ

General Provider Information

NPI Number	:	1881688927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSE M. CASEY L.P.C.

Provider Business Mailing Address
First Line	:	1411 E ORANGEWOOD AVE
Second Line	:	UNIT 203
City	:	PHOENIX
State	:	AZ
Zip	:	85020-5133
Country	:	US
Telephone Number	:	602-466-1740
Fax Number	:	602-466-1741

Provider Business Practice Location Address
First Line	:	6320 E THOMAS RD
Second Line	:	SUITE 311
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7077
Country	:	US
Telephone Number	:	602-432-3844
Fax Number	:	602-466-1741

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

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	07/08/2007

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