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General NPI Number Information
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NPI Number | 1063901650
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Entity Type | Organization
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Legal Business Name | CASTLE COUNSELING PLLC
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 05/09/2018
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Provider Practice Location Address
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Address Line | 1840 FIDDLER CT
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4450
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Country | US
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Telephone | 850-631-2028
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Fax |
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Provider Business Mailing Address
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Address Line | 1840 FIDDLER CT
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4450
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Country | US
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Telephone | 850-631-2028
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. WALTER CASTLE
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Credential | LCSW. MCAP
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Telephone | 850-631-2028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | SW6086
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License Number State | FL
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