Provider Demographics
NPI:1740034636
Name:CASTRO, ALEXANDRA (LPC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SEWAREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07077-1117
Mailing Address - Country:US
Mailing Address - Phone:732-585-0742
Mailing Address - Fax:
Practice Address - Street 1:421 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1526
Practice Address - Country:US
Practice Address - Phone:908-829-4839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01026900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional