Provider Demographics
NPI:1700242302
Name:CASTILLO, PHILIP (LCSW)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
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 1:2475 CANAL ST STE 106
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6549
Mailing Address - Country:US
Mailing Address - Phone:504-962-7020
Mailing Address - Fax:504-962-7025
Practice Address - Street 1:2475 CANAL ST STE 106
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6549
Practice Address - Country:US
Practice Address - Phone:504-962-7020
Practice Address - Fax:504-962-7025
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA127271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical