Provider Demographics
NPI:1639392483
Name:CASTRO, DAVID (LMSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CASTRO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3354 83RD ST
Mailing Address - Street 2:APT E2
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1466
Mailing Address - Country:US
Mailing Address - Phone:917-804-6499
Mailing Address - Fax:
Practice Address - Street 1:3354 83RD ST
Practice Address - Street 2:APT E2
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-1466
Practice Address - Country:US
Practice Address - Phone:917-804-6499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074746104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker