Castleberry, Dianna Michelle

Castleberry, Dianna Michelle is an sole proprietor health care provider with primary practice located at 1166 Mason St , Barry IL 62312-1137. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Castleberry, Dianna Michelle can be contacted via phone (217) 335-2961.

Contact Information

Primary practice address
1166 Mason St Barry IL 62312-1137
Phone: (217) 335-2961
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1437759701
LBN Legal business name Castleberry, Dianna Michelle
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 27th, 2020
Last updated Nov 24th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437759701 NPPES
Illinois MEDICAID 85-364764

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