Provider Demographics
NPI:1073855235
Name:DEL CASTILLO, JENNIFER (LPC, CRC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DEL CASTILLO
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4375 SCOTLAND CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-8454
Mailing Address - Country:US
Mailing Address - Phone:404-548-8335
Mailing Address - Fax:770-470-0530
Practice Address - Street 1:4375 SCOTLAND CT
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-8454
Practice Address - Country:US
Practice Address - Phone:404-548-8335
Practice Address - Fax:770-470-0530
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA