Dennis Kevin Caskey, LCSW
Individual provider Active NPI Clinical Social Worker · Cameron Park, CA
NPI 1811279664 · NPPES record last updated Jun 24, 2020
Key facts
- NPI
- 1811279664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 94853 (CA)
- Practice address
- 3104 Ponte Morino Dr Ste 100
Cameron Park, CA 95682-8282 - Phone
- (305) 556-2056
- NPI assigned
- Sep 16, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Full Circle Health Inc
Practice addresses (Care Compare)
6565 W Emerald St
Boise, ID 83704-8737
Phone (208) 514-2510
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Full Circle Health |
Federally qualified health center | Corporate Officer | Jun 24, 2024 |
| Full Circle Health Inc |
Federally qualified health center | Corporate Officer | Jun 24, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240823001030 | ID | Practitioner - Clinical Social Worker | 9931648870 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94853 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Full Circle Health, Inc. | Current |
Accepting new patients | |
| El Dorado County Community Health Center | Current |
Accepting new patients |
Locations
3104 Ponte Morino Dr
Ste 100
Cameron Park, CA 95682
Phone (305) 556-2056
777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 94853 | CA | Yes |
Addresses
Primary practice location
3104 Ponte Morino Dr Ste 100
Cameron Park, CA 95682-8282
Mailing address
3108 Ponte Morino Dr Ste 130
Cameron Park, CA 95682-8278
Phone (530) 556-2056
Other providers in Cameron Park, CA
- Cameron Park Medical Group
- Cameron Park Physical Therapy Center, Inc.
- Cameron Park Rehab
- Cancer and Blood Specialty Clinic
- Breanna Canclini
- Janey Arlene Caylor
- Center for Functional & Integrative Medicine, Inc
- Shama Beth Chaiken
- Allen Earl Chantry
- Helen Yen-Hwa Cheng
All providers in Cameron Park, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.