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NPI Code Detail

MEDICARE: MR. ALEC BRADEN CASTILLA

MEDICARE: MR. ALEC BRADEN CASTILLA
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
1101YM0800XMental Health Counselor1074WV

General Provider Information

NPI Number : 1144184573
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALEC BRADEN CASTILLA
Provider Business Mailing Address
First Line : 1 KENTON DR
Second Line :
City : CHARLESTON
State : WV
Zip : 25311-1256
Country : US
Telephone Number : 304-408-3292
Fax Number :
Provider Business Practice Location Address
First Line : 1 KENTON DR STE 200
Second Line :
City : CHARLESTON
State : WV
Zip : 25311-1256
Country : US
Telephone Number : 304-408-3292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 04/13/2026

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Directions to “ MR. ALEC BRADEN CASTILLA ” Practice Location

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