Provider Demographics
NPI:1437364775
Name:CASTELLANO, DOLORES C (MA, LPC, PLLC,)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:C
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:MA, LPC, PLLC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 W NOLANA AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3089
Mailing Address - Country:US
Mailing Address - Phone:956-560-3310
Mailing Address - Fax:956-618-2889
Practice Address - Street 1:612 W NOLANA AVE STE 420
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504
Practice Address - Country:US
Practice Address - Phone:956-560-3310
Practice Address - Fax:956-318-2889
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179016403Medicaid