Healthcare Provider Details

I. General information

NPI: 1396458576
Provider Name (Legal Business Name): ASHLEY CASTRO COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5242 PLAINFIELD AVE NE STE C
GRAND RAPIDS MI
49525-1084
US

IV. Provider business mailing address

4792 FOREST VALE RD
PIERSON MI
49339-9782
US

V. Phone/Fax

Practice location:
  • Phone: 269-806-9971
  • Fax:
Mailing address:
  • Phone: 616-951-1127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY CASTRO
Title or Position: OWNER
Credential:
Phone: 616-951-1127