Provider Demographics
NPI:1255866901
Name:CASTRO, NATASHA (LMSW)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2324
Mailing Address - Country:US
Mailing Address - Phone:516-850-7790
Mailing Address - Fax:516-374-9640
Practice Address - Street 1:144 GROVE AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2324
Practice Address - Country:US
Practice Address - Phone:516-850-7790
Practice Address - Fax:516-374-9640
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097565-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker