Provider Demographics
NPI:1013626241
Name:CASTOR, DANA LYNN (CRSW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:LYNN
Last Name:CASTOR
Suffix:
Gender:F
Credentials:CRSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 EMERALD ST STE 203
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3619
Mailing Address - Country:US
Mailing Address - Phone:603-352-1016
Mailing Address - Fax:603-352-1018
Practice Address - Street 1:160 EMERALD ST STE 203
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3619
Practice Address - Country:US
Practice Address - Phone:603-352-1016
Practice Address - Fax:603-352-1018
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0431175T00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175T00000XOther Service ProvidersPeer Specialist