Provider Demographics
NPI:1336973049
Name:NICASTRO, KEVIN (LMSW)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:NICASTRO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 E WEST HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4426
Mailing Address - Country:US
Mailing Address - Phone:301-233-6917
Mailing Address - Fax:
Practice Address - Street 1:4350 E WEST HWY STE 200
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4426
Practice Address - Country:US
Practice Address - Phone:301-233-6917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32090104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker