Provider Demographics
NPI:1164128963
Name:CASTANEDA, MANET (LPC)
Entity Type:Individual
Prefix:
First Name:MANET
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 BISSONNET ST STE 289
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3112
Mailing Address - Country:US
Mailing Address - Phone:832-673-5290
Mailing Address - Fax:
Practice Address - Street 1:4545 BISSONNET ST STE 289
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3112
Practice Address - Country:US
Practice Address - Phone:832-673-5290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health