Provider Demographics
NPI:1760930093
Name:CASTILLO, DELIANNA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:DELIANNA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 E 203RD ST
Mailing Address - Street 2:APT 4F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1413
Mailing Address - Country:US
Mailing Address - Phone:646-428-5171
Mailing Address - Fax:
Practice Address - Street 1:2940 GRAND CONCOURSE
Practice Address - Street 2:STE 1D-E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-2611
Practice Address - Country:US
Practice Address - Phone:347-577-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096943-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker