Provider Demographics
NPI:1093978637
Name:CASBON, TODD STEVEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:STEVEN
Last Name:CASBON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E CARMEL DR STE D400
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4813
Mailing Address - Country:US
Mailing Address - Phone:317-290-6738
Mailing Address - Fax:
Practice Address - Street 1:301 E CARMEL DR STE D400
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4813
Practice Address - Country:US
Practice Address - Phone:317-290-6738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042138A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical