Provider Demographics
NPI:1194326330
Name:CASTLE, CAITLYN (BCBA)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:CASTLE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:849 FETTER AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-2254
Mailing Address - Country:US
Mailing Address - Phone:812-914-2109
Mailing Address - Fax:
Practice Address - Street 1:2676 CHARLESTOWN RD STE 3
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2574
Practice Address - Country:US
Practice Address - Phone:812-914-2109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1-20-44896103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-20-44896OtherBACB