Provider Demographics
NPI:1205354446
Name:BROWN, CASEY (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 HAWTHORNE LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5106
Mailing Address - Country:US
Mailing Address - Phone:484-467-5092
Mailing Address - Fax:
Practice Address - Street 1:55 S MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-6755
Practice Address - Country:US
Practice Address - Phone:302-454-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA$$$$$$$$$Medicaid