Provider Demographics
NPI:1184513111
Name:CASTELNAU VENTURA, MARY STEPHANIE
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:STEPHANIE
Last Name:CASTELNAU VENTURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7217 W 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-5221
Mailing Address - Country:US
Mailing Address - Phone:201-687-4784
Mailing Address - Fax:
Practice Address - Street 1:7217 W 30TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-5221
Practice Address - Country:US
Practice Address - Phone:201-687-4784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician