MEDICARE: DR. SEAN D CASEY BCBA, PHD

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	103K00000X	Behavior Analyst	1-08-4290	NJ
2	103K00000X	Behavior Analyst	190003377	PA

General Provider Information

NPI Number	:	1417251901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN D CASEY BCBA, PHD

Provider Business Mailing Address
First Line	:	110 IVY ROCK LN
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-2826
Country	:	US
Telephone Number	:	515-771-6248
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 IVY ROCK LN
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-2826
Country	:	US
Telephone Number	:	515-771-6248
Fax Number	:	484-454-5770

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

Provider Enumeration Date	:	12/27/2010
Last Update Date	:	01/13/2023

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