MEDICARE: ALLISON NICOLE CASCARILLA PH.D., BCBA-D, LBA

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	7401000640	MI

General Provider Information

NPI Number	:	1427715226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON NICOLE CASCARILLA PH.D., BCBA-D, LBA

Provider Business Mailing Address
First Line	:	1645 N HAGADORN RD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-2228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 3 MILE RD NW
Second Line	:	SUITE 200
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49544-1691
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

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

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	03/17/2026

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