=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790608693
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SANDRA CASTLE LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2026
-----------------------------------------------------
Last Update Date | 07/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 186 BRENNA BLVD STE 500
-----------------------------------------------------
City | SALYERSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41465-7722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-943-8100
-----------------------------------------------------
Fax | 606-349-8150
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 186 BRENNA BLVD STE 500
-----------------------------------------------------
City | SALYERSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41465-7722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-943-8100
-----------------------------------------------------
Fax | 606-349-8150
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCSW00001679
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------