Provider Demographics
NPI:1982219002
Name:KASTLER, ZANESSA D (LCSW)
Entity Type:Individual
Prefix:
First Name:ZANESSA
Middle Name:D
Last Name:KASTLER
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 1:3824 LOCKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-5509
Mailing Address - Country:US
Mailing Address - Phone:575-317-0463
Mailing Address - Fax:
Practice Address - Street 1:1462 CRAN
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:NM
Practice Address - Zip Code:88124
Practice Address - Country:US
Practice Address - Phone:575-317-0463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-1133331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical