Healthcare Provider Details

I. General information

NPI: 1912769100
Provider Name (Legal Business Name): JENNYFFER JOSEFINA CASTILLO VENTURA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N 12TH AVE BLDG B
ARCADIA FL
34266-8752
US

IV. Provider business mailing address

10443 NW 3RD ST
PEMBROKE PINES FL
33026-5951
US

V. Phone/Fax

Practice location:
  • Phone: 863-494-1242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT4832
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: