Provider Demographics
NPI:1508155748
Name:CASTELLANO, CLAIRE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6014 BRIDGE WATER CIR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3004
Mailing Address - Country:US
Mailing Address - Phone:904-280-1059
Mailing Address - Fax:
Practice Address - Street 1:6014 BRIDGE WATER CIR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-3004
Practice Address - Country:US
Practice Address - Phone:904-280-1059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC 142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional