Provider Demographics
NPI:1134233703
Name:CASTILLO, ANTHONY R (LISW)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:R
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7961
Mailing Address - Country:US
Mailing Address - Phone:740-412-1974
Mailing Address - Fax:
Practice Address - Street 1:398 CHARLES ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7961
Practice Address - Country:US
Practice Address - Phone:740-412-1974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00071891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI-0007189OtherL.I.S.W.