Provider Demographics
NPI:1578773941
Name:CASTLE, STEPHANIE GAIL (MA)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:GAIL
Last Name:CASTLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 DOGWOOD DR.
Mailing Address - Street 2:APT. H
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052
Mailing Address - Country:US
Mailing Address - Phone:765-482-6968
Mailing Address - Fax:
Practice Address - Street 1:1050 W 42ND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-3301
Practice Address - Country:US
Practice Address - Phone:317-931-2379
Practice Address - Fax:317-931-2393
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor