Provider Demographics
NPI:1225463748
Name:CASTELL, KATIE LYNN (LCSW-R)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:CASTELL
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 LINCOLN AVENUE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-452-2372
Mailing Address - Fax:845-452-8563
Practice Address - Street 1:46 LINCOLN AVENUE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-452-2372
Practice Address - Fax:845-452-8563
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055323104100000X
NYR054865-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker