Reba Dianne Casebolt, CRC, LAC, CI

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LAC1249 Issued in LA

Practice address

13170 Dutchtwn PT Ave Apt 914
Gonzales, LA 70737-0104

Phone

(504) 458-0497

Fax

(800) 697-3631

NPI assigned

Nov 4, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1306147517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13170 DUTCHTOWN POINT AVENUE #914",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707371317",
            "telephone_number": "504-458-0497",
            "fax_number": "800-697-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13170 DUTCHTWN PT AVE APT 914",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707370104",
            "telephone_number": "504-458-0497",
            "fax_number": "800-697-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEBOLT",
        "first_name": "REBA",
        "middle_name": "DIANNE",
        "name_prefix": "Ms.",
        "credential": "CRC, LAC, CI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": "LAC1249",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": "CRC00109065",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caro Clinic, a.P.M.C.
• Caro Clinic, LLC
• Richard J. Caro, M.D.
• Sidnie Carr
• Courtney Jean Carroll
• Annie Mary Cash- Harris
• Melissa Bailey Cassard, LOTR
• Marcie Jill Causey, PHARMD
• Cortlynn Cavalier
• Alexis Marie Chidester

• Counselor in Gonzales, LA
• Providers in Gonzales, LA by specialty
• Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.