MEDICARE: MANDALYN CASTANON LMHC, LPCC

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	101YM0800X	Mental Health Counselor	15249	CA
2	101YM0800X	Mental Health Counselor	39004002A	IN

General Provider Information

NPI Number	:	1467083253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANDALYN CASTANON LMHC, LPCC

Provider Business Mailing Address
First Line	:	1141 W SHAW AVE STE 200
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3713
Country	:	US
Telephone Number	:	765-896-5030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1141 W SHAW AVE STE 200
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3713
Country	:	US
Telephone Number	:	765-896-5030
Fax Number	:

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

Provider Enumeration Date	:	01/30/2020
Last Update Date	:	12/29/2025

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