MEDICARE: CRISTAL CASTILLO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1073192886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTAL CASTILLO LCSW

Provider Business Mailing Address
First Line	:	2685 UNIVERSITY AVE APT 61C
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-3362
Country	:	US
Telephone Number	:	929-548-2540
Fax Number	:

Provider Business Practice Location Address
First Line	:	2685 UNIVERSITY AVE APT 61C
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-3362
Country	:	US
Telephone Number	:	929-548-2540
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	05/26/2026

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Directions to “ CRISTAL CASTILLO LCSW” Practice Location

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