Healthcare Provider Details

I. General information

NPI: 1821831488
Provider Name (Legal Business Name): FRANK C CASTILLO LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 91ST ST
JACKSON HEIGHTS NY
11372-7961
US

IV. Provider business mailing address

197 BRIDGE ST APT 19
STAMFORD CT
06905-4432
US

V. Phone/Fax

Practice location:
  • Phone: 718-706-1663
  • Fax:
Mailing address:
  • Phone: 347-666-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number014773
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: