Healthcare Provider Details

I. General information

NPI: 1205214293
Provider Name (Legal Business Name): JAMIE CASTILLO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE RINGELBERG LPCC

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 68TH ST SE
GRAND RAPIDS MI
49548-6927
US

IV. Provider business mailing address

300 68TH ST SE
GRAND RAPIDS MI
49548-6927
US

V. Phone/Fax

Practice location:
  • Phone: 616-455-5000
  • Fax: 616-455-5960
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1205214293
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401222372
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: