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NPI Code Detail

MEDICARE: JAVIER DEL CASTILLO LCSW, CAC III

MEDICARE: JAVIER DEL CASTILLO LCSW, CAC III
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1903CO
21041C0700XClinical Social Worker991653CO

General Provider Information

NPI Number : 1801985924
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAVIER DEL CASTILLO LCSW, CAC III
Provider Business Mailing Address
First Line : 3239 INDEPENDENCE RD
Second Line :
City : CANON CITY
State : CO
Zip : 81212-9380
Country : US
Telephone Number : 720-404-2058
Fax Number : 303-832-1492
Provider Business Practice Location Address
First Line : 3239 INDEPENDENCE RD
Second Line :
City : CANON CITY
State : CO
Zip : 81212-9380
Country : US
Telephone Number : 720-404-2058
Fax Number : 719-275-4209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 08/26/2020

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