Provider Demographics
NPI:1336488311
Name:CASTANEDA, HELENA H (LMSW)
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:H
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:HELENA
Other - Middle Name:H
Other - Last Name:SCHEMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15330 HAVERSHAM PL
Mailing Address - Street 2:
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-9621
Mailing Address - Country:US
Mailing Address - Phone:228-239-1268
Mailing Address - Fax:
Practice Address - Street 1:15330 HAVERSHAM PL
Practice Address - Street 2:
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-9621
Practice Address - Country:US
Practice Address - Phone:228-239-1268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC79971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00018213Medicaid