Provider Demographics
NPI:1881988145
Name:CASTELL, ROCHELLE MARIE (M ED, BCBA)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:MARIE
Last Name:CASTELL
Suffix:
Gender:F
Credentials:M ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-3122
Mailing Address - Country:US
Mailing Address - Phone:774-644-7281
Mailing Address - Fax:
Practice Address - Street 1:3 W LAKE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-3122
Practice Address - Country:US
Practice Address - Phone:774-644-7281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-11-8440103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst