Provider Demographics
NPI:1710721808
Name:CASTO, BENITA ANN
Entity type:Individual
Prefix:
First Name:BENITA
Middle Name:ANN
Last Name:CASTO
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 1:54 W MAIN ST APT 202
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-1549
Mailing Address - Country:US
Mailing Address - Phone:240-818-5215
Mailing Address - Fax:
Practice Address - Street 1:54 W MAIN ST APT 202
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-1549
Practice Address - Country:US
Practice Address - Phone:240-818-5215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141437101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional