Provider Demographics
NPI:1417253089
Name:CASTOR, SHERYL L (MA)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:L
Last Name:CASTOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:MANSON
Mailing Address - State:WA
Mailing Address - Zip Code:98831-0500
Mailing Address - Country:US
Mailing Address - Phone:509-679-7267
Mailing Address - Fax:
Practice Address - Street 1:160 WAPATO WAY
Practice Address - Street 2:
Practice Address - City:MANSON
Practice Address - State:WA
Practice Address - Zip Code:98831
Practice Address - Country:US
Practice Address - Phone:509-679-7267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60163653101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health