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General NPI Number Information
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NPI Number | 1851191084
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Entity Type | Organization
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Legal Business Name | CASTAWAY COUNSELING
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 122 W SYLVANIA AVE
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City | NEPTUNE CITY
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State | NJ
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Zip | 07753-6368
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Country | US
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Telephone | 732-592-9013
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Fax |
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Provider Business Mailing Address
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Address Line | 2114 KENNETH RD
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City | POINT PLEASANT BORO
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State | NJ
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Zip | 08742-4432
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Country | US
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Telephone | 908-890-9004
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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. SEAN MALLON
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Credential | LPC, CSC
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Telephone | 908-890-9004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health 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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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