Provider Demographics
NPI:1235511387
Name:KASEY THOMAS, MA, BCBA, LLC
Entity Type:Organization
Organization Name:KASEY THOMAS, MA, BCBA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:785-766-9006
Mailing Address - Street 1:23400 LEIGHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2777
Mailing Address - Country:US
Mailing Address - Phone:785-766-9006
Mailing Address - Fax:
Practice Address - Street 1:23400 LEIGHWOOD DR
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-2777
Practice Address - Country:US
Practice Address - Phone:785-766-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-07-3944103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty