Provider Demographics
NPI:1104873900
Name:UNGER, CASEY (LPC)
Entity type:Individual
Prefix:MS
First Name:CASEY
Middle Name:
Last Name:UNGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:UNGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:197 TONKAWA DR
Mailing Address - Street 2:
Mailing Address - City:PAIGE
Mailing Address - State:TX
Mailing Address - Zip Code:78659-4842
Mailing Address - Country:US
Mailing Address - Phone:979-255-4176
Mailing Address - Fax:
Practice Address - Street 1:197 TONKAWA DR
Practice Address - Street 2:
Practice Address - City:PAIGE
Practice Address - State:TX
Practice Address - Zip Code:78659-4842
Practice Address - Country:US
Practice Address - Phone:979-255-4176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17991101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154839803Medicaid
TX2329777OtherEAP PROVIDER ID NUMBER
TX154839802Medicaid