Provider Demographics
NPI:1780657502
Name:CASTLE, JANINE (PHD)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:CASTLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3555
Mailing Address - Street 2:555 N. DUKE ST
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-3555
Mailing Address - Country:US
Mailing Address - Phone:717-544-2730
Mailing Address - Fax:
Practice Address - Street 1:2100 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015307103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7929739OtherAETNA - NON HMO
PA2275776000OtherIBC/AMERIHEALTH 65
PA50055761OtherCBC
PA50055761OtherCBC