Provider Demographics
NPI:1861592578
Name:CASEY, ROBERT PATRICK (LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:PATRICK
Last Name:CASEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 W MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3771
Mailing Address - Country:US
Mailing Address - Phone:281-338-6269
Mailing Address - Fax:
Practice Address - Street 1:614 W MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3771
Practice Address - Country:US
Practice Address - Phone:281-338-6269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01991101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional