Provider Demographics
NPI:1679769319
Name:KASTNER, LINDA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:KASTNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 232
Mailing Address - Street 2:11506 N.E. 23RD ST.
Mailing Address - City:NICOMA PARK
Mailing Address - State:OK
Mailing Address - Zip Code:73066
Mailing Address - Country:US
Mailing Address - Phone:405-769-4799
Mailing Address - Fax:405-260-9465
Practice Address - Street 1:11506 N.E. 23RD ST.
Practice Address - Street 2:
Practice Address - City:NICOMA PARK
Practice Address - State:OK
Practice Address - Zip Code:73066
Practice Address - Country:US
Practice Address - Phone:405-769-4799
Practice Address - Fax:405-260-9465
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3068101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health