MEDICARE: MANUEL CASTILLO LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LMSW-12810	AZ

General Provider Information

NPI Number	:	1457682171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANUEL CASTILLO LMSW

Provider Business Mailing Address
First Line	:	3033 N CENTRAL AVE STE 145
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2808
Country	:	US
Telephone Number	:	623-583-3001
Fax Number	:	623-974-6721

Provider Business Practice Location Address
First Line	:	15525 N 83RD AVE STE 104
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-5820
Country	:	US
Telephone Number	:	480-964-2273
Fax Number	:	623-505-3272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2010
Last Update Date	:	04/23/2026

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