Provider Demographics
NPI:1588086987
Name:CASALI, NICK (BS)
Entity type:Individual
Prefix:
First Name:NICK
Middle Name:
Last Name:CASALI
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CROOK ST
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1304
Mailing Address - Country:US
Mailing Address - Phone:774-277-1806
Mailing Address - Fax:
Practice Address - Street 1:8 CROOK ST
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1304
Practice Address - Country:US
Practice Address - Phone:774-277-1806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent