Provider Demographics
NPI:1467200600
Name:CASTLE, SHAWN (CDCA)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:CASTLE
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6358 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3559
Mailing Address - Country:US
Mailing Address - Phone:740-784-1814
Mailing Address - Fax:
Practice Address - Street 1:5689 AVERY RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8765
Practice Address - Country:US
Practice Address - Phone:614-710-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty