Provider Demographics
NPI:1285359513
Name:CASANOVA, KAELA ALESSANDRA (MS, BCBA, LBA)
Entity type:Individual
Prefix:MS
First Name:KAELA
Middle Name:ALESSANDRA
Last Name:CASANOVA
Suffix:
Gender:
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15911 NACOGDOCHES RD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-1107
Mailing Address - Country:US
Mailing Address - Phone:210-590-2107
Mailing Address - Fax:
Practice Address - Street 1:5210 THOUSAND OAKS DR # 1301
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-6974
Practice Address - Country:US
Practice Address - Phone:737-242-7925
Practice Address - Fax:762-204-8637
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7714103K00000X
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician