Provider Demographics
NPI:1386804003
Name:CASEY, CORBY (MA LMHC)
Entity type:Individual
Prefix:MR
First Name:CORBY
Middle Name:
Last Name:CASEY
Suffix:
Gender:M
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:926 SE FORT KING ST APT C
Mailing Address - Street 2:B
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2355
Mailing Address - Country:US
Mailing Address - Phone:352-286-8348
Mailing Address - Fax:352-624-2321
Practice Address - Street 1:850 NE 36TH TER
Practice Address - Street 2:B
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-2050
Practice Address - Country:US
Practice Address - Phone:352-624-2321
Practice Address - Fax:352-624-2321
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health