Provider Demographics
NPI:1679819445
Name:CASTLEBERRY & ASSOCIATES COUNSELING AND TESTING SERVICES, LLC
Entity Type:Organization
Organization Name:CASTLEBERRY & ASSOCIATES COUNSELING AND TESTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HINRICHS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-884-0146
Mailing Address - Street 1:2800 SAN MATEO BLVD NE STE 108
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3166
Mailing Address - Country:US
Mailing Address - Phone:505-803-2138
Mailing Address - Fax:
Practice Address - Street 1:2800 SAN MATEO BLVD NE STE 100
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3166
Practice Address - Country:US
Practice Address - Phone:505-884-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-22
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1202103T00000X
1041C0700X
NMCNP-02002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty