Basic Information
| Provider Information | |||||||||
| NPI: | 1205094216 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASEMENT | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | LSCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3707 SW 6TH AVE | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666062084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852704630 | ||||||||
| FaxNumber: | 7852704601 | ||||||||
| Practice Location | |||||||||
| Address1: | 3707 SW 6TH AVE | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666062084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852704630 | ||||||||
| FaxNumber: | 7852704601 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2008 | ||||||||
| LastUpdateDate: | 06/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 4017 | KS | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 110661014 | 01 | KS | MEDICARE PTAN | OTHER | 200554440C | 05 | KS | MEDICAID |