MEDICARE: KATHY L. CASTONGUAY LCPC,NCC

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	CC3265	ME

General Provider Information

NPI Number	:	1750363883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY L. CASTONGUAY LCPC,NCC

Provider Business Mailing Address
First Line	:	16 WILDBERRY LN
Second Line	:
City	:	GREENVILLE
State	:	ME
Zip	:	04441-3203
Country	:	US
Telephone Number	:	207-671-6121
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 WILDBERRY LN
Second Line	:
City	:	GREENVILLE
State	:	ME
Zip	:	04441-3203
Country	:	US
Telephone Number	:	207-671-6121
Fax Number	:

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	11/06/2016

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