Provider Demographics
NPI:1538516695
Name:CASTLE, KIMBERLY (BA , CPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:CASTLE
Suffix:
Gender:F
Credentials:BA , CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N MILLER ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2086
Mailing Address - Country:US
Mailing Address - Phone:509-888-2118
Mailing Address - Fax:509-888-5885
Practice Address - Street 1:701 N MILLER ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2086
Practice Address - Country:US
Practice Address - Phone:509-888-2118
Practice Address - Fax:509-888-5885
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG 60226500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health