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NPI Profile for CASEY R DE VITO in SOUTHAVEN, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Counselor |
101Y00000X |
| NPI # | 1396549697 |
|
| Status | Active | |
| Credentials | LPC (Licensed Professional Counselor) | |
| Entity | Individual | |
| Enumeration date | 04/03/2025 | |
| Last updated | 07/14/2025 - About 11 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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CASEY R DE VITO
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CASEY R DE VITO, LPC