Provider Demographics
NPI:1508190570
Name:CASTELLOW, JOAN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:ELIZABETH
Last Name:CASTELLOW
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 1:4107 MEDICAL PKWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3735
Mailing Address - Country:US
Mailing Address - Phone:512-323-2292
Mailing Address - Fax:
Practice Address - Street 1:4107 MEDICAL PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3735
Practice Address - Country:US
Practice Address - Phone:512-323-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX412081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical