Individual provider Active NPI

Casey Larae Cassetty, LCSW

  • Clinical Social Worker
  • Bowling Green, KY
National Provider Identifier
1164891768
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
253613 Issued in KY
Practice address
661 31W Bypass
Suite G
Bowling Green, KY 42104-4968
Phone
(364) 203-8188
Fax
(949) 437-3743
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 253613 KY Primary
Clinical Social Worker 1041C0700X 7362 KY

Addresses

Primary practice location

661 31W Bypass
Suite G
Bowling Green, KY 42104-4968

Mailing address

661 31W Bypass
Suite G
Bowling Green, KY 42104-4968
Phone (270) 779-3490

Other names 1

  • Casey Larae Coursey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210329001161 KY Practitioner - Clinical Social Worker 1153738695 Practice locations: Bowling Green, KY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

661 31W Bypass
Suite G
Bowling Green, KY 42101

661 U S 31 W Bypass
Suite G
Bowling Green, KY 42101
Phone (364) 203-8188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
253613KYMDClinical Social Worker
7362KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Casey Coursey LCSW Emdr Current Accepting new patients

Locations

661 US 31W Byp
Ste G
Bowling Green, KY 42101
Phone (364) 203-8188

343 W 3rd St
Russellville, KY 42276

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1164891768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 31W BYPASS",
            "address_2": "SUITE G",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044968",
            "telephone_number": "270-779-3490",
            "fax_number": "949-437-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 31W BYPASS",
            "address_2": "SUITE G",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044968",
            "telephone_number": "364-203-8188",
            "fax_number": "949-437-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSETTY",
        "first_name": "CASEY",
        "middle_name": "LARAE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253613",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "7362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "COURSEY",
            "middle_name": "LARAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.