Healthcare Provider Details

I. General information

NPI: 1184304396
Provider Name (Legal Business Name): ANGIE PATRICIA CASTILLO MIRANDA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 EMERGENCY ROOM DR
CHAPEL HILL NC
27599-5035
US

IV. Provider business mailing address

701 GREEN VALLEY RD STE 100
GREENSBORO NC
27408-7096
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-3658
  • Fax:
Mailing address:
  • Phone: 910-601-5060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC019336
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: