Provider Demographics
NPI:1275188120
Name:CASTILLO, JANINE NICOLE KAY (LPC)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:NICOLE KAY
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9422 E GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5001
Mailing Address - Country:US
Mailing Address - Phone:417-321-2441
Mailing Address - Fax:
Practice Address - Street 1:2100 N BROADWAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2526
Practice Address - Country:US
Practice Address - Phone:303-312-9926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0014935101YM0800X
COLPC.0016569101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health