MEDICARE: MS. TERESA C KASTL M.A., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	#428	CO

General Provider Information

NPI Number	:	1164586335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERESA C KASTL M.A., LPC

Provider Business Mailing Address
First Line	:	50 S STEELE ST
Second Line	:	#810
City	:	DENVER
State	:	CO
Zip	:	80209-2805
Country	:	US
Telephone Number	:	303-355-9609
Fax Number	:	303-388-6057

Provider Business Practice Location Address
First Line	:	50 S STEELE ST
Second Line	:	#810
City	:	DENVER
State	:	CO
Zip	:	80209-2805
Country	:	US
Telephone Number	:	303-355-9609
Fax Number	:	303-388-6057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	07/08/2007

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