Provider Demographics
NPI:1336625417
Name:CASTLES, ALYSSA PAIGE (LMSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:PAIGE
Last Name:CASTLES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30589
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73140-3589
Mailing Address - Country:US
Mailing Address - Phone:405-769-3301
Mailing Address - Fax:405-769-9685
Practice Address - Street 1:105 E. SANTA FE AVENUE
Practice Address - Street 2:
Practice Address - City:CARNEY
Practice Address - State:OK
Practice Address - Zip Code:74832
Practice Address - Country:US
Practice Address - Phone:405-769-1300
Practice Address - Fax:405-865-2323
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5565104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker