Provider Demographics
NPI:1558133959
Name:MCCASTLE, YVONNE (LPC, BCTMH, CAMS)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:MCCASTLE
Suffix:
Gender:F
Credentials:LPC, BCTMH, CAMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 KESWICK MANOR DR
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-1542
Mailing Address - Country:US
Mailing Address - Phone:770-858-7796
Mailing Address - Fax:
Practice Address - Street 1:123 KESWICK MANOR DR
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-1542
Practice Address - Country:US
Practice Address - Phone:770-858-7796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013563101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional