Provider Demographics
NPI:1023161841
Name:CASEY, MAUREEN E (BA)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:E
Last Name:CASEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MRS
Other - First Name:MAUREEN
Other - Middle Name:E
Other - Last Name:GORMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:585 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1906
Mailing Address - Country:US
Mailing Address - Phone:508-854-3320
Mailing Address - Fax:508-753-5051
Practice Address - Street 1:76 SUMMER ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-5783
Practice Address - Country:US
Practice Address - Phone:978-343-2433
Practice Address - Fax:978-343-0791
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2220002001OtherBCBS SUBSTANCE ABUSE
MAM18684OtherMENTAL HEALTH
MA1308785Medicaid
MA1306421Medicaid
MA1306421Medicaid