Provider Demographics
NPI:1346016409
Name:MCCASLIN, RONALD EDWARD JR (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:EDWARD
Last Name:MCCASLIN
Suffix:JR
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HOUSTON ST STE 200A
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-1979
Mailing Address - Country:US
Mailing Address - Phone:630-397-8347
Mailing Address - Fax:
Practice Address - Street 1:201 HOUSTON STREET
Practice Address - Street 2:SUITE 200A
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-1979
Practice Address - Country:US
Practice Address - Phone:630-397-8347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028863363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health