Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Casey Corullo Boersma, MA, BCBA

Individual provider Behavior Analyst · NPI 1689204042

Casey Corullo Boersma, MA, BCBA is a Behavior Analyst in Fort Wayne, Indiana. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
BCBA — Board Certified Behavior Analyst
Designs and supervises applied behaviour analysis programmes, often for autism.

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Practice location Address checks out

12219 Golden Harvest Dr
Fort Wayne, IN 46845-9030
Phone: (260) 467-0090
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X

Record details

NPI number1689204042
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , BCBA
Sole proprietorNo
NPI enumeratedJanuary 24, 2020
Last updated in NPPESJanuary 24, 2020
Certification dateJanuary 24, 2020

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