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General NPI Number Information
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NPI Number | 1427205533
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Entity Type | Individual
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Provider Name | KEVIN VINCENT NICASTRO LICSW
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Gender | Male
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 60 PERSEVERANCE WAY 2ND FL
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City | HYANNIS
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State | MA
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Zip | 02601
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Country | US
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Telephone | 508-815-5160
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Fax | 508-862-0590
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Provider Business Mailing Address
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Address Line | 60 PERSEVERANCE WAY 2ND FL
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City | HYANNIS
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State | MA
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Zip | 02601
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Country | US
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Telephone | 508-815-5160
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Fax | 508-862-0590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW111818
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License Number State | MA
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