Provider Demographics
NPI:1902977929
Name:PUZEY, CASEY (LCPC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:PUZEY
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 E 25TH ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7519
Mailing Address - Country:US
Mailing Address - Phone:208-201-5876
Mailing Address - Fax:
Practice Address - Street 1:2235 E 25TH ST
Practice Address - Street 2:SUITE 290
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7519
Practice Address - Country:US
Practice Address - Phone:208-201-5876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-3231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health