Provider Demographics
NPI:1104539683
Name:COLYER, CASEY L (LMT, LCDC)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:L
Last Name:COLYER
Suffix:
Gender:
Credentials:LMT, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S COIT RD APT 2014
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-1238
Mailing Address - Country:US
Mailing Address - Phone:940-252-4229
Mailing Address - Fax:
Practice Address - Street 1:401 S COIT RD APT 2014
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-1238
Practice Address - Country:US
Practice Address - Phone:940-252-4229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14851101YA0400X
TXMT131857225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty