Provider Demographics
NPI:1407132806
Name:CASTRILLI, MICHAEL D (LMHC, CAP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:D
Last Name:CASTRILLI
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 CITRUS TOWER BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2712
Mailing Address - Country:US
Mailing Address - Phone:352-404-8921
Mailing Address - Fax:352-404-8922
Practice Address - Street 1:235 CITRUS TOWER BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2712
Practice Address - Country:US
Practice Address - Phone:352-404-8921
Practice Address - Fax:352-404-8922
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-29
Last Update Date:2011-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9741101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health