Casey Rae De Vito, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3238 Issued in MS

Practice address

8626 Airways Blvd
Southaven, MS 38671-2603

Phone

(662) 772-5937

Fax

(662) 772-5940

NPI assigned

Apr 3, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Desoto Family Counseling Center PLLCGroup PAC ID 1254511686, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Desoto Family Counseling Center PLLC

  • Community/Behavioral Health Agency
  • Southaven, MS
  • NPI 1912214792

  MS, Professional

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1396549697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COUNTY ROAD 108",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389653911",
            "telephone_number": "601-341-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8626 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712603",
            "telephone_number": "662-772-5937",
            "fax_number": "662-772-5940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 County Road 108",
            "address_purpose": "LOCATION",
            "city": "Water Valley",
            "state": "MS",
            "postal_code": "389653911",
            "country_code": "US",
            "telephone_number": "601-341-3633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE VITO",
        "first_name": "CASEY",
        "middle_name": "RAE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "3238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley T Davis, RDN LD
• Tabitha Elizabeth Davis, DC
• Radhi Daya, OD
• DC Direct
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• Roger L Decker, AGACNP-BC
• Deep Blue Retina, PLLC
• Jessica James Defore
• Crystal Brianna Delgado
• Delta Endoscopy Center, P.C.

• All providers in Southaven, MS
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.