Provider Demographics
NPI:1306235700
Name:CASEY, MAKEBA LARKIN (MSW, LCSWA)
Entity type:Individual
Prefix:MS
First Name:MAKEBA
Middle Name:LARKIN
Last Name:CASEY
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4397 FEDERAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8116
Mailing Address - Country:US
Mailing Address - Phone:336-496-2838
Mailing Address - Fax:
Practice Address - Street 1:4397 FEDERAL DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8116
Practice Address - Country:US
Practice Address - Phone:336-496-2838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
P0217111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)