Coretta Casley, MASTER

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

424 Guyton CT
Mullins, SC 29574-6014

Phone

(843) 423-8292

Fax

(843) 423-8294

NPI assigned

Oct 13, 2020

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 13, 2020.

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1003414947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1011",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295711011",
            "telephone_number": "843-423-8292",
            "fax_number": "843-423-8294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 GUYTON CT",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746014",
            "telephone_number": "843-423-8292",
            "fax_number": "843-423-8294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 Cheraw St",
            "address_purpose": "LOCATION",
            "city": "Bennettsville",
            "state": "SC",
            "postal_code": "295122422",
            "country_code": "US",
            "telephone_number": "843-479-5683",
            "fax_number": "843-423-8294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASLEY",
        "first_name": "CORETTA",
        "credential": "MASTER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251S00000X",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mullins, SC
• Addiction (Substance Use Disorder) Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.