Healthcare Provider Details

I. General information

NPI: 1396865184
Provider Name (Legal Business Name): MEGAN CASTLE FACER M.S., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. MEGAN LOUISE CASTLE

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAPITOLA DR STE. 310
DURHAM NC
27713-4496
US

IV. Provider business mailing address

100 CAPITOLA DR STE. 310
DURHAM NC
27713-4496
US

V. Phone/Fax

Practice location:
  • Phone: 919-474-6389
  • Fax:
Mailing address:
  • Phone: 919-474-6389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1220
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1220
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: