Provider Demographics
NPI:1053455378
Name:MAGNUSON, KASEY R (LLP)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:R
Last Name:MAGNUSON
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:MS
Other - First Name:KASEY
Other - Middle Name:
Other - Last Name:MEUNIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1466 CHASE LANE DR SW
Mailing Address - Street 2:
Mailing Address - City:BYRON CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49315-9586
Mailing Address - Country:US
Mailing Address - Phone:616-443-7150
Mailing Address - Fax:616-732-6392
Practice Address - Street 1:325 84TH ST SW STE 103
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-9350
Practice Address - Country:US
Practice Address - Phone:616-805-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361003491103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7509106890OtherBLUE CROSS BLUE SHIELD