Provider Demographics
NPI:1184437915
Name:CASTANEDA, MARYURY
Entity type:Individual
Prefix:
First Name:MARYURY
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 W ESPLANADE AVE S STE 603
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3447
Mailing Address - Country:US
Mailing Address - Phone:504-579-9040
Mailing Address - Fax:
Practice Address - Street 1:3300 W ESPLANADE AVE S STE 603
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3447
Practice Address - Country:US
Practice Address - Phone:504-579-9040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health