Healthcare Provider Details

I. General information

NPI: 1841848272
Provider Name (Legal Business Name): KONSTANCE CASTLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 E COLORADO BLVD STE 208
PASADENA CA
91107-6622
US

IV. Provider business mailing address

2555 E COLORADO BLVD STE 208
PASADENA CA
91107-6622
US

V. Phone/Fax

Practice location:
  • Phone: 763-361-3988
  • Fax:
Mailing address:
  • Phone: 443-219-7125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107685
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number59944
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: