Provider Demographics
NPI:1578845772
Name:CASTORINA, JOHN R (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:CASTORINA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 92ST.
Mailing Address - Street 2:PHN
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1688
Mailing Address - Country:US
Mailing Address - Phone:212-400-0939
Mailing Address - Fax:
Practice Address - Street 1:115 E 92ND ST
Practice Address - Street 2:PHN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1688
Practice Address - Country:US
Practice Address - Phone:212-433-0939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health