MEDICARE: MS. MARLEEN ROSE CRUZ 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	1041C0700X	Clinical Social Worker	LCSW-E-040	GU

General Provider Information

NPI Number	:	1497636302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARLEEN ROSE CRUZ CASTRO LCSW

Provider Business Mailing Address
First Line	:	PO BOX 23873
Second Line	:
City	:	BARRIGADA
State	:	GU
Zip	:	96921-3873
Country	:	US
Telephone Number	:	671-686-7060
Fax Number	:

Provider Business Practice Location Address
First Line	:	665 S MARINE CORPS DR BLDG STE 102
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96913-3572
Country	:	US
Telephone Number	:	671-686-7060
Fax Number	:

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

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	09/11/2025

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