Provider Demographics
NPI:1417251901
Name:CASEY, SEAN D (BCBA, PHD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:D
Last Name:CASEY
Suffix:
Gender:M
Credentials:BCBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IVY ROCK LN
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2826
Mailing Address - Country:US
Mailing Address - Phone:515-771-6248
Mailing Address - Fax:
Practice Address - Street 1:110 IVY ROCK LN
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2826
Practice Address - Country:US
Practice Address - Phone:515-771-6248
Practice Address - Fax:484-454-5770
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-08-4290103K00000X
PA190003377103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst