Provider Demographics
NPI:1376371906
Name:CASTRO, LAURA NATALIA (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:NATALIA
Last Name:CASTRO
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 1:279 DULLIS CIR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4989
Mailing Address - Country:US
Mailing Address - Phone:336-608-0973
Mailing Address - Fax:
Practice Address - Street 1:279 DULLIS CIR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4989
Practice Address - Country:US
Practice Address - Phone:336-608-0973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0124921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical