Provider Demographics
NPI:1558163352
Name:CASTER, KENISHA
Entity type:Individual
Prefix:
First Name:KENISHA
Middle Name:
Last Name:CASTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66558
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70896-6558
Mailing Address - Country:US
Mailing Address - Phone:225-922-0478
Mailing Address - Fax:888-965-7288
Practice Address - Street 1:PO BOX 66558
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70896-6558
Practice Address - Country:US
Practice Address - Phone:225-922-0478
Practice Address - Fax:888-965-7288
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
ZZ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty