Provider Demographics
NPI:1427320894
Name:CASWELL, PATRICIA HENNING (LPC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:HENNING
Last Name:CASWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SHORT DR., PO BOX 19
Mailing Address - Street 2:
Mailing Address - City:PRUDENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48651-0019
Mailing Address - Country:US
Mailing Address - Phone:989-366-1515
Mailing Address - Fax:989-366-1501
Practice Address - Street 1:1401 SHORT DR.
Practice Address - Street 2:
Practice Address - City:PRUDENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48651-0019
Practice Address - Country:US
Practice Address - Phone:989-366-1515
Practice Address - Fax:989-366-1501
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional