Provider Demographics
NPI:1366529471
Name:CASTANEDA, IRENE (LCSWR)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:MS
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:INGHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSWR
Mailing Address - Street 1:222 WEST MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561
Mailing Address - Country:US
Mailing Address - Phone:516-432-1432
Mailing Address - Fax:516-889-7899
Practice Address - Street 1:344 FULTON AVE
Practice Address - Street 2:HISPANIC COUNSELING CENTER
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550
Practice Address - Country:US
Practice Address - Phone:516-538-2613
Practice Address - Fax:516-538-2613
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04111111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0831Medicare ID - Type Unspecified