Provider Demographics
NPI:1376556498
Name:CASTANEDA, GUADALUPE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GUADALUPE
Middle Name:
Last Name:CASTANEDA
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 1:10181 SAIGON DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-5427
Mailing Address - Country:US
Mailing Address - Phone:915-590-9813
Mailing Address - Fax:915-590-3137
Practice Address - Street 1:1600 N LEE TREVINO DR
Practice Address - Street 2:C-7
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-5169
Practice Address - Country:US
Practice Address - Phone:915-593-5676
Practice Address - Fax:915-593-1199
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSW00101F9Medicare ID - Type Unspecified
TXP10931Medicare UPIN