Provider Demographics
NPI:1316111461
Name:CASEY, BOBBI SUE (LMSW)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:SUE
Last Name:CASEY
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 534
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49016-0534
Mailing Address - Country:US
Mailing Address - Phone:269-350-3411
Mailing Address - Fax:269-979-7766
Practice Address - Street 1:6204 LOVERS LANE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002
Practice Address - Country:US
Practice Address - Phone:289-350-3411
Practice Address - Fax:269-979-7766
Is Sole Proprietor?:No
Enumeration Date:2008-04-19
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085952104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801085952OtherLICENSE