Provider Demographics
NPI:1639877160
Name:CASTELLANOS, CELESTE N (BCBA)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:N
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 E VISTA RIDGE MALL DR APT 7825
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4037
Mailing Address - Country:US
Mailing Address - Phone:910-818-7815
Mailing Address - Fax:
Practice Address - Street 1:2600 MACARTHUR BLVD UNIT 302
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-6747
Practice Address - Country:US
Practice Address - Phone:469-458-6832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-23-64198103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst