MEDICARE: MR. STEPHEN A CASWELL M. ED.

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	103TS0200X	School Psychologist		AZ

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	:	1932249398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN A CASWELL M. ED.

Provider Business Mailing Address
First Line	:	1226 W OSBORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3618
Country	:	US
Telephone Number	:	602-707-2007
Fax Number	:	602-707-2040

Provider Business Practice Location Address
First Line	:	1225 W CLARENDON AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3359
Country	:	US
Telephone Number	:	602-707-2230
Fax Number	:	602-707-2040

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/26/2007

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