Provider Demographics
NPI:1154084424
Name:CASTLE, SAMANTHA (LAC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CASTLE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 EVERLY CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3710
Mailing Address - Country:US
Mailing Address - Phone:856-651-8045
Mailing Address - Fax:
Practice Address - Street 1:6102 HAMILTON WAY
Practice Address - Street 2:
Practice Address - City:EASTAMPTON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08060-1673
Practice Address - Country:US
Practice Address - Phone:484-515-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist