Provider Demographics
NPI:1952068728
Name:CASTRO, MARIA MARGARITA
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:MARGARITA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W. 1ST ST.
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-5805
Mailing Address - Country:US
Mailing Address - Phone:308-675-3345
Mailing Address - Fax:308-675-3342
Practice Address - Street 1:707 W. 1ST ST.
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-5805
Practice Address - Country:US
Practice Address - Phone:308-675-3345
Practice Address - Fax:308-675-3342
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1620101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)