Healthcare Provider Details

I. General information

NPI: 1811811128
Provider Name (Legal Business Name): CALEB ELLIOT CASEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4706 COTTAGE GROVE RD STE 100
MADISON WI
53716-1354
US

IV. Provider business mailing address

4706 COTTAGE GROVE RD STE 100
MADISON WI
53716-1354
US

V. Phone/Fax

Practice location:
  • Phone: 855-607-8242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number136160
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: