Provider Demographics
NPI:1093493249
Name:CASTELLANO, SAMANTHA (MA, LPC, LPAT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:MA, LPC, LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 KIRKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5108
Mailing Address - Country:US
Mailing Address - Phone:973-768-5205
Mailing Address - Fax:
Practice Address - Street 1:6-8 GATES AVE STE 3B
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3777
Practice Address - Country:US
Practice Address - Phone:973-604-6881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00892300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional