Provider Demographics
NPI:1457676694
Name:CASTRO, OLGA JACQUELINE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:OLGA
Middle Name:JACQUELINE
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CHATHAM AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1032
Mailing Address - Country:US
Mailing Address - Phone:973-333-3914
Mailing Address - Fax:
Practice Address - Street 1:175 CHATHAM AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502-1032
Practice Address - Country:US
Practice Address - Phone:973-333-3914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053848001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical