Provider Demographics
NPI:1194400283
Name:SUMNER, CASEY MONEL (PHD)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:MONEL
Last Name:SUMNER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 SE 53RD ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-4415
Mailing Address - Country:US
Mailing Address - Phone:352-229-0940
Mailing Address - Fax:
Practice Address - Street 1:303 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0956
Practice Address - Country:US
Practice Address - Phone:352-895-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMH23568101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty