MEDICARE: MRS. KALENA SUANN CASTANEDA

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	101YP2500X	Professional Counselor	1265873624	CO

General Provider Information

NPI Number	:	1265873624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KALENA SUANN CASTANEDA

Provider Business Mailing Address
First Line	:	2513 BUCHANAN DR
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1270
Country	:	US
Telephone Number	:	970-433-0248
Fax Number	:

Provider Business Practice Location Address
First Line	:	3198 F RD STE 103
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81504-4039
Country	:	US
Telephone Number	:	970-779-4928
Fax Number	:

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

Provider Enumeration Date	:	07/15/2013
Last Update Date	:	08/23/2024

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