Healthcare Provider Details

I. General information

NPI: 1598941460
Provider Name (Legal Business Name): MICHELLE CASTRO-WRIGHT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 COURTLANDT AVE
BRONX NY
10451-5013
US

IV. Provider business mailing address

579 COURTLANDT AVE
BRONX NY
10451-5013
US

V. Phone/Fax

Practice location:
  • Phone: 718-485-2100
  • Fax: 718-485-2101
Mailing address:
  • Phone: 718-485-2100
  • Fax: 718-485-2101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number079084-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number098703-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: