Provider Demographics
NPI:1518774876
Name:GARNETT, CASEY REBECCA (BCABA)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:REBECCA
Last Name:GARNETT
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 METAIRIE RD STE 515
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4333
Mailing Address - Country:US
Mailing Address - Phone:504-833-6730
Mailing Address - Fax:
Practice Address - Street 1:10 COMMERCE CT
Practice Address - Street 2:
Practice Address - City:ELMWOOD
Practice Address - State:LA
Practice Address - Zip Code:70123-3225
Practice Address - Country:US
Practice Address - Phone:504-833-6730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0-24-15621106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst