Provider Demographics
NPI:1831529601
Name:CARDINAL THERAPY PLLC
Entity type:Organization
Organization Name:CARDINAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLOW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-814-5513
Mailing Address - Street 1:5808 BALCONES DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4255
Mailing Address - Country:US
Mailing Address - Phone:512-814-5513
Mailing Address - Fax:
Practice Address - Street 1:5808 BALCONES DR
Practice Address - Street 2:SUITE 201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4255
Practice Address - Country:US
Practice Address - Phone:512-814-5513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX412081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty