Provider Demographics
NPI:1235872730
Name:DEMUNN, CASEY L (LMHC, MS)
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:L
Last Name:DEMUNN
Suffix:
Gender:F
Credentials:LMHC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W ONEIDA ST STE 1
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2670
Mailing Address - Country:US
Mailing Address - Phone:315-596-9965
Mailing Address - Fax:
Practice Address - Street 1:22 W ONEIDA ST STE 1
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2670
Practice Address - Country:US
Practice Address - Phone:315-596-9965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health