Provider Demographics
NPI:1124994967
Name:CASTANOS, VALERIA (LAC)
Entity type:Individual
Prefix:MS
First Name:VALERIA
Middle Name:
Last Name:CASTANOS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WYNNWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3528
Mailing Address - Country:US
Mailing Address - Phone:732-993-6403
Mailing Address - Fax:732-626-4544
Practice Address - Street 1:984 BERGEN AVE
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2335
Practice Address - Country:US
Practice Address - Phone:732-993-6403
Practice Address - Fax:732-626-4544
Is Sole Proprietor?:No
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00741800101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)