Provider Demographics
NPI:1427686658
Name:CASTREJON, MOSIAH (LPC, NCC)
Entity type:Individual
Prefix:
First Name:MOSIAH
Middle Name:
Last Name:CASTREJON
Suffix:
Gender:
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 S INTERSTATE PLAZA #100
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-3210
Mailing Address - Country:US
Mailing Address - Phone:385-236-4500
Mailing Address - Fax:801-305-4075
Practice Address - Street 1:101 S MAIN ST
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-3210
Practice Address - Country:US
Practice Address - Phone:208-232-8840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-9538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health