Provider Demographics
NPI:1083394787
Name:CASTILLO, ALBERTO LEANDRO JR (LPCC0020682)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:LEANDRO
Last Name:CASTILLO
Suffix:JR
Gender:M
Credentials:LPCC0020682
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5878 BRENNAN AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-4101
Mailing Address - Country:US
Mailing Address - Phone:719-371-0027
Mailing Address - Fax:
Practice Address - Street 1:2116 HOLLOW BROOK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1442
Practice Address - Country:US
Practice Address - Phone:719-249-0984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0020682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health