Provider Demographics
NPI:1407234701
Name:CASTANIA, MIKE
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:
Last Name:CASTANIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 E CHERRY CREEK SOUTH DR
Mailing Address - Street 2:940
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1518
Mailing Address - Country:US
Mailing Address - Phone:303-322-7108
Mailing Address - Fax:303-322-9989
Practice Address - Street 1:4500 E CHERRY CREEK SOUTH DR
Practice Address - Street 2:940
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1518
Practice Address - Country:US
Practice Address - Phone:303-322-7108
Practice Address - Fax:303-322-9989
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health