Provider Demographics
NPI:1346492972
Name:CASWELL, LIBBY A (MS BCBA)
Entity Type:Individual
Prefix:
First Name:LIBBY
Middle Name:A
Last Name:CASWELL
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 N. LIBERTY CIR W.
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-9742
Mailing Address - Country:US
Mailing Address - Phone:812-663-2273
Mailing Address - Fax:812-663-2275
Practice Address - Street 1:1314 N. LIBERTY CIR W.
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-4724
Practice Address - Country:US
Practice Address - Phone:812-663-2273
Practice Address - Fax:812-663-2275
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-08-4008103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300010157Medicaid