Provider Demographics
NPI:1285725192
Name:CASILES, MARTHA HARTLEY (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:HARTLEY
Last Name:CASILES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 DOVE HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02556-2815
Mailing Address - Country:US
Mailing Address - Phone:508-563-7505
Mailing Address - Fax:508-495-1342
Practice Address - Street 1:197 PALMER AVE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2806
Practice Address - Country:US
Practice Address - Phone:508-873-1208
Practice Address - Fax:508-495-1342
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA107680101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO7917OtherBLUE CROSS/BLUE SHIELD
MA18074800OtherMAGELLAN
MA18074800OtherMAGELLAN