Healthcare Provider Details

I. General information

NPI: 1043980394
Provider Name (Legal Business Name): DAVID CASTANEDA MPS, LPCC, LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5972 CAHILL AVE STE 112A
INVER GROVE HEIGHTS MN
55076-1521
US

IV. Provider business mailing address

3725 18TH AVE S
MINNEAPOLIS MN
55407-2820
US

V. Phone/Fax

Practice location:
  • Phone: 612-314-6704
  • Fax: 612-444-5561
Mailing address:
  • Phone: 619-865-5582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5638
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: