Healthcare Provider Details

I. General information

NPI: 1922942010
Provider Name (Legal Business Name): ANDREW DAVID CASTILLO LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 TALCOTTVILLE RD STE 31 # 117
VERNON CT
06066-5261
US

IV. Provider business mailing address

35 TALCOTTVILLE RD STE 31 # 117
VERNON CT
06066-5261
US

V. Phone/Fax

Practice location:
  • Phone: 860-406-3054
  • Fax:
Mailing address:
  • Phone: 860-406-3054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number46.009615
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: