Healthcare Provider Details

I. General information

NPI: 1437783784
Provider Name (Legal Business Name): JESSIKA G DE CASTRO-JOHNSTON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON ST
TAUNTON MA
02780-3960
US

IV. Provider business mailing address

19 HIGHLAND ST
NORWOOD MA
02062-3279
US

V. Phone/Fax

Practice location:
  • Phone: 508-828-9116
  • Fax:
Mailing address:
  • Phone: 781-915-7686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10001851
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: