| Organization Name: | BRENDA LEE CASEY, LLC |
| NPI Number: | 1033424585 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENDA LEE CASEY (COUNSELOR) |
| Mailing Address: | 106 Four Seasons Shopping Ctr Suite 103b Chesterfield |
| State: | MO US |
| Postal Code: | 630173173 |
| Phone Number: | 6364842733 |
| Fax Number: | 3143929558 |
| NPI Enumeration Date: | 08/09/2010 |
| NPI Last Update Date: | 08/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2002029846 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |