Healthcare Provider Details

I. General information

NPI: 1992620330
Provider Name (Legal Business Name): CARMEN CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 EDWARDS ACCESS RD
EDWARDS CO
81632-5633
US

IV. Provider business mailing address

PO BOX 3715
AVON CO
81620-3715
US

V. Phone/Fax

Practice location:
  • Phone: 970-855-7378
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933333
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: