Provider Demographics
NPI:1578866802
Name:CASALLAS, FLORA (PSYDLPC, CADC)
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:
Last Name:CASALLAS
Suffix:
Gender:F
Credentials:PSYDLPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1379 REED LN
Mailing Address - Street 2:
Mailing Address - City:KINTNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18930-9433
Mailing Address - Country:US
Mailing Address - Phone:121-571-5567
Mailing Address - Fax:
Practice Address - Street 1:500 N WEST ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2366
Practice Address - Country:US
Practice Address - Phone:215-345-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACADC- 9078101YA0400X
NYCASAC -13295101YA0400X
NY13295101YA0400X
VT000466101YA0400X
PAPC008222101YP2500X
PA008222101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)