Provider Demographics
NPI:1881187185
Name:CASTILLO, ANDREW D (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:D
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 S NATCHEZ AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-1325
Mailing Address - Country:US
Mailing Address - Phone:773-304-8829
Mailing Address - Fax:
Practice Address - Street 1:2259 S DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-4232
Practice Address - Country:US
Practice Address - Phone:872-281-7575
Practice Address - Fax:773-801-0084
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490201811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical