Healthcare Provider Details

I. General information

NPI: 1467083253
Provider Name (Legal Business Name): MANDALYN CASTANON LMHC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MANDALYN HALE

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 W SHAW AVE STE 200
FRESNO CA
93711-3713
US

IV. Provider business mailing address

1141 W SHAW AVE STE 200
FRESNO CA
93711-3713
US

V. Phone/Fax

Practice location:
  • Phone: 765-896-5030
  • Fax:
Mailing address:
  • Phone: 765-896-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15249
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39004002A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: