Provider Demographics
NPI:1679079750
Name:CASTILLO, ZAHEDI MANUEL (MHC)
Entity Type:Individual
Prefix:MR
First Name:ZAHEDI
Middle Name:MANUEL
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 WALTON AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-6535
Mailing Address - Country:US
Mailing Address - Phone:917-576-4638
Mailing Address - Fax:
Practice Address - Street 1:4511 3RD AVE FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1563
Practice Address - Country:US
Practice Address - Phone:646-951-6352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health