Healthcare Provider Details

I. General information

NPI: 1538091228
Provider Name (Legal Business Name): MAXWELL DAVID CASTILLO RODRIGUEZ TLMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MAXWELL DAVID ROBNETT

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4080 1ST AVE NE STE 101
CEDAR RAPIDS IA
52402-3160
US

IV. Provider business mailing address

30 LINCOLN AVE APT 19
IOWA CITY IA
52246-2272
US

V. Phone/Fax

Practice location:
  • Phone: 319-382-2077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number138681
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: