Provider Demographics
NPI:1497247084
Name:CASTO, STEPHANIE (LICSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CASTO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5368 RIPLEY RD
Mailing Address - Street 2:
Mailing Address - City:COTTAGEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25239-7063
Mailing Address - Country:US
Mailing Address - Phone:681-217-0400
Mailing Address - Fax:681-217-0600
Practice Address - Street 1:2998 CHARLESTON RD STE 5A
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-5810
Practice Address - Country:US
Practice Address - Phone:681-217-0400
Practice Address - Fax:681-217-0600
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WVDP009451461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor