Provider Demographics
NPI:1366457277
Name:YOUNG CASTLEBERRY, LINDA F (LCSW LSOTP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:F
Last Name:YOUNG CASTLEBERRY
Suffix:
Gender:F
Credentials:LCSW LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 REPUBLIC DRIVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:469-766-2303
Mailing Address - Fax:972-509-9062
Practice Address - Street 1:555 REPUBLIC DRIVE
Practice Address - Street 2:SUITE 109
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074
Practice Address - Country:US
Practice Address - Phone:469-766-2303
Practice Address - Fax:972-509-9062
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS267301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS26730OtherCLINICAL SOCIAL WORKER
TX95293OtherTREATMENT PROVIDER
TX95293OtherTREATMENT PROVIDER
TXS26730OtherCLINICAL SOCIAL WORKER