Provider Demographics
NPI:1790774438
Name:KASTRINOS, MARLENE M (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:M
Last Name:KASTRINOS
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9380 SW 72 ST
Mailing Address - Street 2:SUITE B 238
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5489
Mailing Address - Country:US
Mailing Address - Phone:305-667-2430
Mailing Address - Fax:305-271-6773
Practice Address - Street 1:9408 SW 87TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2416
Practice Address - Country:US
Practice Address - Phone:833-769-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-16
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW58841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7449266OtherAETNA
FL887512000Medicaid
FL110688OtherAMERIGROUP ID
FL256975OtherMANAGED HEALTH NETWORK
FLNZ710OtherEMPIRE BLUE CROSS
FL240335OtherWELLCARE
FL9222748OtherPRIVATE HEALTHCARE SYSTEM
FLPVPB 170322OtherAPS HEALTHCARE
FL192456OtherCOMPSYCH
FL256975OtherMANAGED HEALTH NETWORK
FLZ0374Medicare ID - Type Unspecified