Healthcare Provider Details

I. General information

NPI: 1417868282
Provider Name (Legal Business Name): SEPTEMBER LEE CASTEEL LCSW; LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E STATE HIGHWAY 310
MANITOWOC WI
54220-9669
US

IV. Provider business mailing address

100 E STATE HIGHWAY 310
MANITOWOC WI
54220-9669
US

V. Phone/Fax

Practice location:
  • Phone: 262-424-6388
  • Fax:
Mailing address:
  • Phone: 262-424-6388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33987
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9827-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: