MEDICARE: ALYSSA CASTANO MANN MSW. LCSW

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	104100000X	Social Worker	2018013137	MO

General Provider Information

NPI Number	:	1811531809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA CASTANO MANN MSW. LCSW

Provider Business Mailing Address
First Line	:	7043 CORBITT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63130-2448
Country	:	US
Telephone Number	:	314-669-6396
Fax Number	:

Provider Business Practice Location Address
First Line	:	9378 OLIVE BLVD STE 104A
Second Line	:
City	:	OLIVETTE
State	:	MO
Zip	:	63132-3222
Country	:	US
Telephone Number	:	314-669-6396
Fax Number	:

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

Provider Enumeration Date	:	11/01/2019
Last Update Date	:	06/06/2022

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