Provider Demographics
NPI:1306083266
Name:CASEY, SANDRA (MHPP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LEE
Other - Last Name:STAUFFER-NEELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3352 N FUTRALL DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4057
Mailing Address - Country:US
Mailing Address - Phone:479-521-1427
Mailing Address - Fax:479-521-6520
Practice Address - Street 1:701 N MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2912
Practice Address - Country:US
Practice Address - Phone:870-741-2658
Practice Address - Fax:870-741-2722
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator