Provider Demographics
NPI:1235620758
Name:CASTILLO, KIMBERLEY DENNEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:DENNEY
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25640 MOHAWK LN
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-9344
Mailing Address - Country:US
Mailing Address - Phone:815-353-9195
Mailing Address - Fax:
Practice Address - Street 1:643 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-2717
Practice Address - Country:US
Practice Address - Phone:815-353-9195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical