Provider Demographics
NPI:1538618236
Name:NIEMEIER, CASEY
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:NIEMEIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6815 POWDER DR.
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:IN
Mailing Address - Zip Code:46259
Mailing Address - Country:US
Mailing Address - Phone:317-253-7387
Mailing Address - Fax:317-253-7388
Practice Address - Street 1:6815 POWDER DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46259-7757
Practice Address - Country:US
Practice Address - Phone:317-253-7387
Practice Address - Fax:317-253-7388
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007090A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical