Provider Demographics
NPI:1083334239
Name:FOX, CASEY (LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:FOX
Suffix:
Gender:
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8825 34TH AVE NE STE L-143
Mailing Address - Street 2:
Mailing Address - City:QUIL CEDA VILLAGE
Mailing Address - State:WA
Mailing Address - Zip Code:98271-8085
Mailing Address - Country:US
Mailing Address - Phone:405-420-8955
Mailing Address - Fax:
Practice Address - Street 1:420 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:DARRINGTON
Practice Address - State:WA
Practice Address - Zip Code:98241
Practice Address - Country:US
Practice Address - Phone:405-420-8955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7432104100000X
OK203761041C0700X
WA615995561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker