Provider Demographics
NPI:1336206523
Name:CASTERLINE, B. SUE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:B.
Middle Name:SUE
Last Name:CASTERLINE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:B.
Other - Middle Name:SUE
Other - Last Name:HOOLAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 PARK PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-2344
Mailing Address - Country:US
Mailing Address - Phone:407-846-0023
Mailing Address - Fax:407-483-1064
Practice Address - Street 1:206 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2344
Practice Address - Country:US
Practice Address - Phone:407-846-0023
Practice Address - Fax:407-483-1064
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5094101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIN PROCESSMedicaid
FLZ088KOtherBCBS