Provider Demographics
NPI:1538810361
Name:DYCUS, CASEY GUNNELS (LPCMH)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:GUNNELS
Last Name:DYCUS
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-5230
Mailing Address - Country:US
Mailing Address - Phone:615-887-4226
Mailing Address - Fax:
Practice Address - Street 1:2021 21ST AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4342
Practice Address - Country:US
Practice Address - Phone:615-887-4226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3385101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health