MEDICARE: MR. ANTHONY R CASTILLO L.I.S.W.

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	1041C0700X	Clinical Social Worker	I-0007189	OH
2	1041C0700X	Clinical Social Worker	I.2506972	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	I.2506972	OTHER	OH	STATE OF OHIO
2	I-0007189	OTHER	OH	L.I.S.W.

General Provider Information

NPI Number	:	1134233703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY R CASTILLO L.I.S.W.

Provider Business Mailing Address
First Line	:	7840 STATE ROUTE 348
Second Line	:
City	:	OTWAY
State	:	OH
Zip	:	45657-9077
Country	:	US
Telephone Number	:	740-412-1974
Fax Number	:

Provider Business Practice Location Address
First Line	:	7840 STATE ROUTE 348
Second Line	:
City	:	OTWAY
State	:	OH
Zip	:	45657-9077
Country	:	US
Telephone Number	:	740-412-1974
Fax Number	:

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

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	08/04/2025

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