Provider Demographics
NPI:1700265303
Name:BEST, KASEY (MC)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:BEST
Suffix:
Gender:F
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RAYO DEL SOL RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9472
Mailing Address - Country:US
Mailing Address - Phone:703-507-1349
Mailing Address - Fax:
Practice Address - Street 1:2543 WYOMING BLVD NE
Practice Address - Street 2:SUITE A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1037
Practice Address - Country:US
Practice Address - Phone:505-294-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRE-LICENSED101YM0800X
NMT-0186101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health