1528002722 NPI number — MRS. MEMREY CASEY LCSW

Table of content: MRS. MEMREY CASEY LCSW (NPI 1528002722)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528002722 NPI number — MRS. MEMREY CASEY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASEY
Provider First Name:
MEMREY
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528002722
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1320 AUPAPAOHE ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KAILUA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96734-4138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-263-7871
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1320 AUPAPAOHE ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAILUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96734-4138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-263-7871
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  3038 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 3038 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 22739-7 . This is a "HMSA MEDICAL INSURANCE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".