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NPI Code Detail

MEDICARE: LAUREN CASTILLO

MEDICARE: LAUREN CASTILLO
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
1101Y00000XCounselor11931NE
2101YM0800XMental Health Counselor2829NE

General Provider Information

NPI Number : 1497303218
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN CASTILLO
Provider Business Mailing Address
First Line : 11718 S 113TH AVE
Second Line :
City : PAPILLION
State : NE
Zip : 68046-5585
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11404 W DODGE RD STE 300
Second Line :
City : OMAHA
State : NE
Zip : 68154-9603
Country : US
Telephone Number : 402-898-1113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2019
Last Update Date : 02/14/2024

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Directions to “ LAUREN CASTILLO ” Practice Location

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