Provider Demographics
NPI:1689420259
Name:CASTRONOVA, LORRAINE ANN (LCSW)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:ANN
Last Name:CASTRONOVA
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 1:100 DOUBLE BEACH RD
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4909
Mailing Address - Country:US
Mailing Address - Phone:203-315-7962
Mailing Address - Fax:203-655-3452
Practice Address - Street 1:100 DOUBLE BEACH RD
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4909
Practice Address - Country:US
Practice Address - Phone:203-315-7962
Practice Address - Fax:203-655-3452
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8402101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health