Provider Demographics
NPI:1164848727
Name:CASTILLO, VIRGINIA (LCPC)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4522 N NEWLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HARWOOD HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60706-4843
Mailing Address - Country:US
Mailing Address - Phone:773-719-5300
Mailing Address - Fax:
Practice Address - Street 1:4522 N NEWLAND AVE
Practice Address - Street 2:
Practice Address - City:HARWOOD HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60706-4843
Practice Address - Country:US
Practice Address - Phone:773-719-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007788101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional