Provider Demographics
NPI:1255434817
Name:KASTNER, GEORGE DUNN (LCSW)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:DUNN
Last Name:KASTNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 E FLETCHER AVE
Mailing Address - Street 2:S-129
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613
Mailing Address - Country:US
Mailing Address - Phone:813-978-3960
Mailing Address - Fax:813-978-0475
Practice Address - Street 1:3500 E FLETCHER AVE
Practice Address - Street 2:S-129
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-978-3960
Practice Address - Fax:813-978-3960
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLSW34571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z5724Medicare ID - Type Unspecified