MEDICARE: JESSICA CASARREAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-25-411675	FL
2	171M00000X	Case Manager/Care Coordinator		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215742465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CASARREAL

Provider Business Mailing Address
First Line	:	2915 W 5TH ST APT 18E
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-3913
Country	:	US
Telephone Number	:	786-319-2827
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 W 5TH ST APT 18E
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-3913
Country	:	US
Telephone Number	:	786-319-2827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/02/2026

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Directions to “ JESSICA CASARREAL ” Practice Location

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