Provider Demographics
NPI:1831435411
Name:CASTELLO, KATHRYN MICHELLE (MSW, LISW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MICHELLE
Last Name:CASTELLO
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:WATERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:289 HOLLY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8721
Mailing Address - Country:US
Mailing Address - Phone:614-905-2421
Mailing Address - Fax:614-259-6061
Practice Address - Street 1:399 VENTURE DR STE D
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-9520
Practice Address - Country:US
Practice Address - Phone:614-905-2421
Practice Address - Fax:614-259-6061
Is Sole Proprietor?:No
Enumeration Date:2012-12-30
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 12015231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical