Provider Demographics
NPI:1194232975
Name:FASCHING, CALSEY E (PSYD)
Entity type:Individual
Prefix:
First Name:CALSEY
Middle Name:E
Last Name:FASCHING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CALSEY
Other - Middle Name:
Other - Last Name:HOEFLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1451 MERCHANT DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5917
Mailing Address - Country:US
Mailing Address - Phone:847-469-7537
Mailing Address - Fax:847-469-7540
Practice Address - Street 1:1099 HELMO AVE N STE 130
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-6034
Practice Address - Country:US
Practice Address - Phone:847-469-7537
Practice Address - Fax:847-469-7540
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009679103G00000X
MNLP6320103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist