Healthcare Provider Details

I. General information

NPI: 1154881233
Provider Name (Legal Business Name): MATTHEW N CASTON JR. LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W INSTITUTE PL STE 500
CHICAGO IL
60610-8792
US

IV. Provider business mailing address

2735 HASSERT BLVD STE 135
NAPERVILLE IL
60564-5205
US

V. Phone/Fax

Practice location:
  • Phone: 847-440-4479
  • Fax:
Mailing address:
  • Phone: 847-440-4479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.013246
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.013059
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: