MEDICARE: MR. JOSUE CASTRO LCSW

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	101YM0800X	Mental Health Counselor	108001	TX

General Provider Information

NPI Number	:	1467316406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSUE CASTRO LCSW

Provider Business Mailing Address
First Line	:	12370 POTRANCO RD STE 207
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-4261
Country	:	US
Telephone Number	:	830-587-3967
Fax Number	:

Provider Business Practice Location Address
First Line	:	12370 POTRANCO RD STE 207
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-4261
Country	:	US
Telephone Number	:	830-587-3967
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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