Provider Demographics
NPI:1447362108
Name:CASTALDO, CARRIE ANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ANNE
Last Name:CASTALDO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 W ADAMS ST UNIT 317
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3080
Mailing Address - Country:US
Mailing Address - Phone:312-738-9737
Mailing Address - Fax:708-246-7271
Practice Address - Street 1:822 HILLGROVE AVE
Practice Address - Street 2:
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1464
Practice Address - Country:US
Practice Address - Phone:708-254-4583
Practice Address - Fax:708-246-7271
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical