Provider Demographics
NPI:1548561236
Name:LIZANO CASTILLO, GUISSELLE MARIA (LPC)
Entity Type:Individual
Prefix:
First Name:GUISSELLE
Middle Name:MARIA
Last Name:LIZANO 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 1:1111 DOUGLAS AVENUE
Mailing Address - Street 2:MCCARTHY HALL, CATHOLIC CHARITIES
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-5111
Mailing Address - Country:US
Mailing Address - Phone:262-637-8888
Mailing Address - Fax:262-637-0695
Practice Address - Street 1:7114 14TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53143-5448
Practice Address - Country:US
Practice Address - Phone:262-637-8888
Practice Address - Fax:262-637-0695
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4463-125104100000X, 101YM0800X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical