Basic Information
| Provider Information | |||||||||
| NPI: | 1871793968 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASTIGLIONE | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | EDWARD | ||||||||
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| Credential: | MSW, LCSW-BACS, ACSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5959 S SHERWOOD FOREST BLVD | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708166038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257658829 | ||||||||
| FaxNumber: | 2257659196 | ||||||||
| Practice Location | |||||||||
| Address1: | 7777 HENNESSY BLVD STE 7000 | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708080307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257658829 | ||||||||
| FaxNumber: | 2257658283 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2007 | ||||||||
| LastUpdateDate: | 10/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | CA | N | Behavioral Health & Social Service Providers | Social Worker | 104100000X | 11852 | LA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.