Provider Demographics
NPI:1487025235
Name:THOMAS-CASTILLO, MELANIE (PSYD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:THOMAS-CASTILLO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:3120 BURNET AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3022
Mailing Address - Country:US
Mailing Address - Phone:513-585-7700
Mailing Address - Fax:135-585-7778
Practice Address - Street 1:3120 BURNET AVE STE 304
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3022
Practice Address - Country:US
Practice Address - Phone:513-585-7700
Practice Address - Fax:513-585-7778
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7383103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical