Provider Demographics
NPI:1508562802
Name:CASTELINE, LORA L (MS, LPC, NCC, CAADC)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:L
Last Name:CASTELINE
Suffix:
Gender:F
Credentials:MS, LPC, NCC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-1504
Mailing Address - Country:US
Mailing Address - Phone:570-259-3031
Mailing Address - Fax:
Practice Address - Street 1:610 NORTH 8TH STREET
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-1780
Practice Address - Country:US
Practice Address - Phone:570-259-3031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC15189101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional