CASEY CORULLO BOERSMA


Address: 12219 Golden Harvest Dr, Fort Wayne, IN 46845-9030
Phone: 2604670090

CASEY CORULLO BOERSMA (NPI# 1689204042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689204042
Entity Type Individual
Full Name CASEY CORULLO BOERSMA
Credential MA, BCBA
Practice Address 12219 Golden Harvest Dr
Fort Wayne
IN 46845-9030
Practice Telephone 2604670090
Mailing Telephone 2604670090
Enumeration Date 2020-01-24
Last Update Date 2020-01-24
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103K00000X Behavioral Analyst Behavioral Health & Social Service Providers

Office Location

Street Address 12219 GOLDEN HARVEST DR
City FORT WAYNE
State IN
Zip Code 46845-9030

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Taxonomy Information

Taxonomy Code 103K00000X
Grouping Behavioral Health & Social Service Providers
Classification Behavioral Analyst

Taxonomy Definition

A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition]

Providers in the same taxonomy and city

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1063077535 Pathway Aba LLC Behavioral Analyst 5651 Coventry Ln Ste 226, Fort Wayne, IN 46804-7145 2019-05-09
1114495835 Amy Sheefel Behavioral Analyst 201 E Rudisill Blvd Ste B100, Fort Wayne, IN 46806-1738 2018-11-12
1336651736 Great Heights Aba Inc. Behavioral Analyst 343 W Suttenfield St, Fort Wayne, IN 46807-1339 2017-10-26
1851819759 Chelsea Wahl-bridge Behavioral Analyst 2270 Lake Ave Ste 101, Fort Wayne, IN 46805-5360 2017-08-31
1811437999 Jessica Ann Lefever Behavioral Analyst 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 2017-03-08
1831542380 Small Steps - Giant Leaps, Inc. Behavioral Analyst 7429 Nature Trail Dr, Fort Wayne, IN 46835-1425 2016-07-20
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1700241866 Wendy Renee Boehm Behavioral Analyst 7631 Lakeridge Dr, Fort Wayne, IN 46819-1969 2015-12-16
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Competitor

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City FORT WAYNE
Zip Code 46845

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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