Provider Demographics
NPI:1649589144
Name:CASTRO, REBECCA K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:K
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 E 14TH ST
Mailing Address - Street 2:9F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-3106
Mailing Address - Country:US
Mailing Address - Phone:917-208-3520
Mailing Address - Fax:
Practice Address - Street 1:8710 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5204
Practice Address - Country:US
Practice Address - Phone:718-680-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081065-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical