Provider Demographics
NPI:1346427580
Name:CASTEL, STACEY
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:CASTEL
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 1:1346 CORY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-1643
Mailing Address - Country:US
Mailing Address - Phone:215-680-7081
Mailing Address - Fax:215-643-7010
Practice Address - Street 1:1346 CORY DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-1643
Practice Address - Country:US
Practice Address - Phone:215-680-7081
Practice Address - Fax:215-643-7010
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW122909104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker