Provider Demographics
NPI:1013945633
Name:CASTLEBERRY, ELSA CRISTINA (MMFT, LPC)
Entity Type:Individual
Prefix:MS
First Name:ELSA
Middle Name:CRISTINA
Last Name:CASTLEBERRY
Suffix:
Gender:F
Credentials:MMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 CANARY LN
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-4002
Mailing Address - Country:US
Mailing Address - Phone:830-305-5790
Mailing Address - Fax:
Practice Address - Street 1:200 N RIVER ST
Practice Address - Street 2:SUITE 100 H
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5607
Practice Address - Country:US
Practice Address - Phone:830-305-5790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14635101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional